“Caring for dying patients?  Isn’t that sad?” This is the typical response that I hear when I tell someone about my interest in palliative care.  I am Dr. Debbie Harrold, a family physician, and a palliative care physician in Huntsville.

 

When growing up in Niagara Falls, I learned about the concept of working with terminally ill people through my mother’s involvement with hospice and palliative care programs.  I suppose this idea of caring for people when they are dying stayed with me throughout my medical school training at McMaster University and my family medicine training in Sudbury at the Northeastern Ontario Family Medicine program.

 

            While in Sudbury, I was fortunate to cross paths with Dr. Andrew Knight, a palliative care physician.  I say fortunate because throughout my medical school education and my family medicine training, there was never an emphasis on learning about end of life care. 

 

My medical training focused on cure and active, often aggressive, treatment for patients with all forms of illness.  I distinctly remember my internal medicine training where we worked long hours, many times through the night, to keep our patients alive.  During my training, the focus on acute medicine and cure overshadowed any opportunity to learn about caring for the terminally ill through palliative care. 

 

Once immersed in my palliative care training, I fell in love with this area of medicine.  It is sometimes difficult to convince friends, family or even other colleagues of the joy that palliative care brings to my life.  Caring for people with terminal illness is a difficult and often demanding job, but one that I am very passionate about and one that I find very rewarding.

 

In Sudbury, I worked on a busy inpatient palliative care ward in a hospital.  Every day I learned.  I learned about palliative medicine, I learned about people, and I learned about dying.  Interestingly, I also learned about hope, about joy and about love.  I learned what a distinct privilege it is to care for someone who is dying; to be included in the circle of caregivers at this very emotional and special time.

 

For myself, I had never thought much about death or the process of dying.  Even after years in medical school I had not been present at someone’s death.  Sure, I had arrived after the fact to “pronounce” the patient, but I had never experienced the process.  I remember fondly my experience in Sudbury.  Every day I would visit my patients.  I would spend time, real time, one-on-one time, with them.  I would care for them.  Not only by prescribing medicine for them, to help with their pain or other symptoms, but also by providing personal support.  I would sit and talk, hold hands, and answer questions.  We would discuss worries and fears but also we would share stories.  My patients always had stories for me; stories about their lives, loves, hopes and dreams.  We would laugh together and we would cry together, but mostly we would BE together.

 

The act of “being present” is the biggest gift that I learned to share with my palliative patients.  All too often those in the medical community who had been present for these patients while they were growing up, growing old and learning of their terminal diagnoses, have all but disappeared.  The diagnosis of a terminal illness is very scary and can be very lonely.  The focus of palliative care is to be present at this time in someone’s life.  Palliative care providers work very hard bringing active care to improve the quality of life for those who are dying.  The journey through the dying process is but the last journey along the pathway of life.  This very special time in a person’s life deserves active care and the utmost respect.  It is truly an honour to be present during the final stage of life.