A Thank You for Hospice
- 1. Department of Medicine, University of Massachusetts Medical School, USA
Tulgan H (2018) A Thank You for Hospice. JSM Health Educ Prim Health Care 3(2): 1047.
LETTER TO THE EDITOR
Sixty one years ago, my father a Ph.D, M.D, cardiac Physiologist and practicing Cardiologist died from Glioblastoma. I have often, in jest, remarked that were he to be resurrected and placed back in his clinic, with the remarkable changes in medicine that have been made since his death, he wouldn’t know how to begin.
But a recent experience has made me even more aware of what progress we have made in another sphere of medicine, endof-life care. A one hour presentation on Hospice that I attended culminated with how Senator John McCain chose Hospice to end his own battle with the same illness and brought back memories that I have long tried to suppress.
It was ten years later that Dame Ceciley Saunders first promulgated the concept of Hospice and yet another two years before Elizabeth Kubler-Ross introduced us to the five stages of grief with which we are now all so familiar.
So let us painfully backtrack to an era when there were no such entities such as Do Not Resuscitate (DNR), Do Not Intubate (DNI), or Comfort Measures Only (CMO) let alone Hospice.
My father had had his surgery by a friend and colleague, a preeminent Neurosurgeon who happened to have been Harvey Cushing’s first Chief Resident and so he was in a major teaching hospital. As he lapsed into a coma, even then, we were asked to free up his bed so that new patients could be admitted. And so, he was transferred to a smaller local hospital for terminal care. And the care there was kind from a devoted Primary Care Physician and Nursing Staff-there were yet no Oncologists in such hospitals.
The coma lasted eleven weeks and the tumor eroded through the scalp suture line while he was receiving intravenous feedings and tube nourishment. As a fourth year medical student at the time, I felt strongly about the futility of all of this “supportive care” but that was the “state of the art” and when Dad finally succumbed, there was nothing but relief for me and my family. We had long since, without knowing it, been through the Kubler-Ross stages of Denial and Anger, any Bargaining had been to accept the transfer to the nonteaching facility and Depression had permeated us for the entire seven months it took Dad to die, We achieved Acceptance willingly.
Two years ago, as my wife reached her own end-of-life battle, Hospice was there for her-and for all of us and her death was so much less of a painful experience.
How fortunate John McCain was to have had the opportunity to choose Hospice without knowing what it was like sixty one years ago to have the same unrelenting illness!
I have seen so much evolution in medicine in the sixty years since I graduated, but I cannot think of one more important to me and for which I am more grateful than the development of Hospice Care.