Dying vs. Dying Well

It’s not always easy to know if you’re doing the right thing. When you’re medicating at the end of life, you hope that what you are doing, medicating aggressively to achieve symptom control is not only for the benefit of those watching the dying process, but truly for the patient. Because when a patient is transitioning, they alone are in in unique tunnel of transition, the spiritual passage to another realm, and they are no longer conversational and interactive to give feedback on the big-picture meaningfulness of the intervention.

So one hopes that medicating as we do is the right thing in terms of the spiritual need. For, irrespective of whether a patient receives medication or not, they will still pass away - not well in our eyes, but nonetheless pass away. With this question of the big-picture utility of medicating, I ask myself in a devil’s advocate fashion what the worth of medicating is. And every now and again, I get a beautiful answer.

I manage all levels of symptoms all the time, but this case was unique in its stark visible reminder to me that medicating can truly be the panacea needed to melt existential suffering. Our patient had advanced cancer, metastasized throughout his body with tumors along his spine. We tried a very strong, non-drip regimen, which just wasn’t cutting it. Despite the strong non-drip regimen, the patient was gripping the side rails of his hospital bed to bolster himself to remain in a fixed motionless position on his side, such pain as he was in. His head was tucked down in an unnatural position, because anything less was unbearable.

We started the drip, adjusted his global regimen, and titrated everything to comfort, and suddenly a miracle appeared. He went from trying to stay as still in his unnatural position as possible, to resting comfortably on his back. After weeks of endless suffering he was finally alright. He passed peacefully with the drip.

When one sees the change from pain to peace, from suffering to solace, from bracing to acceptance, one knows that hospice work might just be God’s work. One can question at times if what one does is right in the spiritual scheme of things, but relieving suffering, at least in this realm, the material one, a is glorious thing. It is these eyewitness experiences which shape us and give us the faith that what we are doing might just be right in the big picture. One hopes so, as there is nothing more rewarding than seeing suffering dissipate.