Friday, May 22, 2009

Quotes from the Front Lines of Palliative Care I

Anyone who has done the "work"of palliative care can come up with quotes that are memorable, either that a team member says or that a patient says. Some funny, some poignant... these little mental "truth bites" are the sound track of our lives as the facilitators of dignity for our patients. Here now a list to get you started:
  1. "Hi we're from Palliative Care... and we're sorry" This is unfortunately not as funny as it would seem. Often our team is called in when situations are out of control, either from the dire emotional stress of the illness or the perceptions of neglect from a stressed family. Nine times out of ten we can remedy this situation, but there are those times we go up in flames.
  2. "I just want to know that I'm doing this right... "  A quote from a woman dying of ovarian cancer. We are all very proud of being in control. I believe that the biggest emotional hurdle we face in our work is the fact that the person faces a betrayal of their sense of identity, but from their own bodies. This woman was a type A control person, who always overachieved, always won, and always did everything right. In the end, her greatest concern was that she was "doing her dying" right.
  3. "No one gets off this planet alive" Reality check for those times when families and/or physicians get the idea that our tragically ill relative will pull through the 50 or so illnesses that they are battling.
  4. "No CPR Doc, when this tire goes flat... throw it in the dump!" New York truck driver with end stage colon cancer reaction on being approached for Advanced Directives. He obviously adamantly refused the offer of death-extending CPR.
  5. "You think better sitting on your ass than laying on your back" Same truck driver when asked whether he wanted to have the family meeting while sitting in a chair or laying in a bed. This is truly a multi-situation piece of wisdom when you stop to think about it.

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