Wednesday, August 16, 2006

Sad and beautiful story

This is a note I received. (I have removed the patient's name and other identifiers, as well as the name of the nurse.) I can't begin to tell you what a privilege it is to be part of a team that can do this kind of thing. The underlying values of our staff often come through, especially during these incredibly important moments.

Dear Mr. Levy,
A great hospital is measured not only by its ability to save lives, but in its skill and sensitivity in aiding and comforting terminally ill patients who can't be cured and their families. My 93-year old mother was admitted to the BID on Thursday for what was initially thought to be pneumonia. Further tests revealed a massive and inoperable massive tumor in her lung that had invaded her rib cage and was strangling vessels to her heart.
My mother had made it clear she wanted no heroic measures. The staff made every reasonable effort to stabilize her prior to moving her home for hospice care. The oncologist who called us late on Friday night to discuss her condition did not sugarcoat the diagnosis or prognosis, nor was he cruelly blunt. Instead,with great skill and wisdom in his choice of words, he clearly helped us understand the grim reality. It helped prepare us for the call that came at 5:30 AM Saturday alerting us to her rapidly deteriorating condition. Twenty-eight years ago, the B.I. did not make it easy to stay with my father during his last hours, and we were not called until well after his death. This time, we could be at her bedside and shepherd her through the process.
During her last hours, my mother was fortunate to be under the care of S.K. We could not have asked for a better nurse or human being.
S. was acutely sensitive to my mother’s discomfort and our monitoring of her changing condition. She explained options clearly and carefully. She cleaned her, adjusted her bedding and took steps to move her from side to side to alleviate other problems. She helped to block undesired intrusions to provide the family with much desired privacy. And in a loving gesture that will forever be remembered by those of us at her bedside, she fluffed my mother’s hair to make it more presentable. In one of our last conversations my mother had said that she wanted to go out "like a lady."
With S’s help, she did. There are many others who helped contribute to my mother's care.
My husband and my sister join me in thanking them and you for the caring kindness and professional expertise of the Beth Israel Deaconess staff.


Anonymous said...

I must say that it gives me some insight on death, which is a tough crossing for all people, I suppose. It certainly is something I think about now and then, and, while it is a natural phenomenon, the fear of it is, nontheless, very present in my mind. As they say, will cross that bridge when I come to it.

Anonymous said...

I certainly never thought about it much before working here, but it is an important part of the daily workings of a hospital. We cannot save everybody -- and, in fact, it is sometimes important to let a person die with dignity rather than prolong life unreasonably. When my sisters and I ended life support for my mom in New York, the ICU nurse at NY Presbyterian supported our decision by saying to me, "We can keep people alive for a long time, but it is not always the right thing to do."

Family members are often called upon to make that final decision, and it can be wrenching. We have a palliative care program at BIDMC that helps patients and family members through those final days and hours.

Anonymous said...

Thank you for sharing this very special letter from a family member of a patient cared for at the BIDMC. I have worked at the medical center for over 25 years and have had the opportunity to be a part of caring for patients in their final days and hours in this life. The nurse is the most visible person to the family and the conduit for the family. There also are many other people who play a role. Attending physician, fellow, resident, intern, respiratory therapist, patient care assistant, social worker, pharmacist, unit coordinator, pharmacy technician and pastor. I'm very happy to be a part of this fine hospital.