“You want to go into what?”
Explaining to family and friends exactly what palliative medicine is and why you’re interested in it can be a daunting task. In my experience, the looks usually go from confused to dismayed to confused again. “How could you possibly want to do something so…morbid? You have to be a very special person to do that.”
What about all the other doctors, the ones who aren’t in hospice and palliative medicine (HPM)? Do they not deal with their own fair share of morbidity and mortality? Sure they do, upon occasion, but they usually cure their patients…right? Savvy surgeons extract a patient’s appendix to cure appendicitis, while insightful internists prescribe antibiotics to cure an infection. But somewhere down the line, the patient who was just cured will get sick again, and maybe next time it’ll be with chronic obstructive pulmonary disease or congestive heart failure. Even if we do eventually discover a cure to those illnesses, others will take their place.
The mortality rate is—and forever will be—100 percent. If the purpose of physicians is to cure everyone of everything, then in the end we all fail.
Fortunately, doctors do much more than cure. We are in the business of healing, and healing does not always mean curing, nor does it even necessarily mean affecting a physical improvement. Physicians may heal in other ways too, encouraging emotional, mental, and spiritual convalescence in patients and their families.
In fact, it is in these “alternative” forms of healing that the HPM physician shines.
Perhaps you can’t cure Mr. Smith’s cancer, but you can help him cope with the many facets of his illness, including his pain and depression, and his wife’s inability to care for him alone. Mrs. Jones may be in a coma, but you are still there to advocate for her and answer her children’s questions.
While some other doctors rush around trying to fight sickness, the HPM physician lives by this quote from Maimonides: “The physician should not treat the disease but the patient who is suffering from it.”
Physicians are here to treat people, not symptoms or germs or diagnoses. It is our greatest responsibility and privilege. And who needs such compassionate treatment more than the critically ill and the dying?
Although it’s true that it is not easy to care for patients who may suffer and die, we must take that risk to be effective physicians. Furthermore, to heal others, we must come to terms with not always being able to cure them and ultimately not being able to cure ourselves. This is a difficult yet rewarding lifelong journey. It is what HPM is all about.
HPM is a wonderful field that I feel honored to have chosen as my own. If you are also a student considering HPM, I highly encourage you to attend the Medical Student Forum at the AAHPM Annual Assembly on Saturday, March 6, 8 am – 4 pm. It may help you answer all the whats, whys, and hows you are bound to be asked by family and friends.
By Jacqui O’Kane, GA-PCOM, OMS-II