When I receive a letter like this, I never know from the salutation if it will be a complaint or something else. This one is clearly something else, and I want to share it with you. Those of you who work in hospitals have doubtless heard similar stories; but for those of you who do not, it provides an insight into the dedication and thoughtfulness of the kind of people who work here and in other places in Boston and throughout the country. It also implicitly provides several pieces of advice to all of us who will go through the experience of terminal illness with a loved one.
Dear Mr. Levy,
My husband was a patient in your hospital in late January through early February 2007. He arrived at BIDMC via a MedFlight from Florida. We, myself, my two sons and their wives, and our BIDMC primary care physician felt that the small community hospital there was not able to deal with the complex issues that my husband seemed to have.
Dr. V continues to be our primary care doctor even though we moved to Florida. We communicate to him via PatientSite and have our annual visits with him each summer and he was constantly aware of my husband's condition while in Florida. He arranged for a hospital-to-hospital admission. We arrived very late on Wednesday January 24th. My husband underwent many tests on Thursday and Friday. We were given a diagnosis on Friday evening.
The diagnosis was not one we wanted to hear; lung, liver and bone cancer, but a course of action was set in place. My husband was to have radiation therapy starting on Monday January 29 to reduce his back pain. The nurses who took care of him were all professional and kind to him and kept me continually informed. They made sure that he was heavily medicated before the transport through the hospital and in radiation treatment, which sounds like a trivial compliment but was actually of utmost importance to minimize the suffering caused by the bone cancer and exacerbated by movement. The nurses in radiation oncology were wonderful and did whatever they could to reduce his pain and make him as comfortable as possible.
On Friday, February 2nd, it became apparent to myself and my sons that my husband was not doing very well, and a CAT scan was scheduled to determine if he had pancreatitis. We asked for a meeting with Dr. X, the hospitalist, to tell us what his condition was at that point. I am sure this type of situation is never easy for a doctor, but Dr. X very clearly and compassionately indicated to us that my husband only had a few days or weeks left to live due to the cancer in the liver being so aggressive. We discussed possible actions with Dr. X and decided to halt all invasive treatments, a course that my family has long agreed to. Dr. X also set up a meeting between us and the palliative care team for later that afternoon. Seemingly within minutes Dr. X had the wheels in motion. All scheduled tests and treatments were cancelled, IVs were stopped and, most importantly to us, had us moved to a private room. Her action was stunning, and we cannot say enough about how fortunate we were to have her during this most difficult time.
We met with RN L that same day. The palliative care folks seem to be a special breed of people doing an incredibly difficult job with kindness and compassion. L promised us that pain relief strategies could be altered such that my husband was not in a drug-induced stupor yet still be relatively pain free. She also stated that we should use the window of opportunity to have friends and family visit as much as possible while he was clear headed because it was all going to be a façade and the cancer would be working just as aggressively though it would not appear so. She was eventually proven correct on all counts.
When my husband woke up Saturday morning he was quite clear-headed for the first time since we arrived back in Boston. We all got to talk with him, and he got to enjoy his children and most importantly, his grandchildren. The private room was wonderful, as we could just close the door and have fun with the grandchildren. He seemed so well that we all expected to see him get up and walk home, giving us pause to our decision to stop treatment. L and Dr. X reminded us, however, that this was just a fleeting condition and that we were doing the right thing. We just cannot write enough times in this letter how great these folks were to us.
L had delivered what she said she would, some very quality time with my husband. Also, I want to stress that because he was able to be on palliative care, his last week at BIDMC was less stressful for both of us. This is an incredible service that makes a very difficult time as humane as possible. These people deserve all possible accolades for their incredible efforts. In general, everyone from the cleaning staff, dietary staff, transporters, medical assistants and nursing staff, were kind and wonderful. So much for the thought of the impersonal big city hospital.
My husband was moved to a nursing home on Friday February 9th. He passed away on Sunday February 11th. Thanks to the efforts of the team, we were at least able to enjoy our final week with our husband and father and he was clear-headed and joking until the day he left BIDMC. We will forever be grateful for that.