Caring for people who are nearing the end of life is an art we can all master… or at least get comfortable with.
When I tell people I’m a palliative care doctor, I typically get one of two responses. The first is usually a well-intentioned, “Oh wow, it takes such a special person to do what you do.”
The second is a straight-faced, slightly awkward, “That’s so depressing. I don’t know how you do it.”
I find both statements equally irksome. Here’s why.
While the first response seems like a nice thing to say, it’s actually entirely untrue. To care for people who are close to the end of their lives doesn’t require you to be special at all. What it does require is a basic ability to show compassion to another human in need.
Showing compassion is something we’re all capable of, but often lose capacity for amidst our discomfort with people who are sick and closer to death than we perceive ourselves to be. (Keep in mind, that you could drop dead as soon as you finish reading this).
A Brief Note on Compassion
Compassion is a muscle. It hides somewhere within each of us. The more we exercise it, the stronger it gets. Unlike other muscles, compassion is contagious. When others show compassion to us or around us, it can spark compassion within us.
Consider this small entertaining experiment I conduct on the regular. Each time I get off my local city bus I choose to either say “thank-you” to the bus driver, or nothing at all. When I say nothing, the people exiting say nothing too. When I choose to say “thank-you” I always hear a cluster of “thank-yous” from other passengers following suit. Every. Single. Time.
Give it a try. You’ll soon see for yourself that I’m not crazy, and that warm and fuzzy attributes like kindness and compassion really are contagious.
The curious thing about compassion is that it means many different things to many people. The essential question is, what does it mean to you? How might you flex your sexy compassionate muscle through the monotony of your day-to-day?
Showing compassion in the context of caring for dying people requires an ability to offer absolute presence. It necessitates an understanding that presence is amongst the best things we can offer someone with limited time. When I say presence, I don’t mean simple mindless physical presence. I’m talking full-on, unabashed, intentional presence. The kind another person sharing your space can feel completely. The kind of presence where you are fully seen, fully heard, and undeniably accepted as you are.
Think back to a time when you felt presence like that. Pretty special, right?
There is No “Us” and “Them”
The second response, “That’s so depressing. I don’t know how you do it,” sends a message that our work is a chore. It implies that there is no value in spending time with dying people. Nothing could be further from the truth. (For more on how thinking about death can lead to a fulfilled life, click here)
People have a natural curiosity about death. Unfortunately, society teaches us that it’s taboo to think about death, much less talk about it. However, this idea that death should be handled behind closed doors can actually cause harm. It suggests that those who are dying should be treated as “other.”
For centuries humans, particularly those living in North America, have actively separated themselves from people who are sick and dying. We institutionalize those who are ill. People die in hospitals and hospices removed from our common living spaces. The funeral industry removes our dead loved ones so we can wash our hands of the messy bits of death.
Even the way we speak can convey a death-denying message. Common terms like, “the sick” and “the dying” act to dehumanize the person who is living with illness. There’s a subtle and often subconscious tendency to separate “us” from “them.” “Them” being fellow mortals who are going through a stage of life we will all go through one day.
If you’re thinking, “damn, humans kind of suck,” you’re not entirely wrong, but please don’t take it personally. We’ve been conditioned to respond like this for way longer than you can take credit for.
What’s important to recognize is that it is possible to talk with and about people who are dying in a way that honours their personhood. After all, dying is really just living. Death is the common ground of humanity.
It’s OK to Be Death Curious
Death is like the car wreck you couldn’t look away from as a kid, but your mom told you to close your eyes… so you did. This natural curiosity about death paired with a broader societal disapproval of all things death and dying creates an awkward tension between our instinct and our conditioning.
I think it’s time we open our eyes. Not to gawk or gossip, but to acknowledge and honour lived experience.
So, next time you see your friendly neighbourhood palliative care doctor or nurse, or hospice volunteer, or death doula, or what have you… before you call them special or tell them that their work is depressing, consider asking them a question or two about what they do. Why do they love it? What parts are challenging? What have they learned from it? I promise it’s so much more than just “special” or “depressing.”
More to come on palliative medicine, what it is, what it isn’t, and why you should care.
And don’t forget! One day you will die.