Sunday, June 29, 2008

"Ay, que se muera"

i'm not gonna go into medicine. i promise myself i'll never go to medical school. however, if i did, i'd go into geriatrics or really any field keen on palliative care. p.c.=treatment that recognizes boundaries, admit defeats, confirms that their are not always cures and concentrates on easing, calming the quality of life the patient has left.

yesterday i wrote my last update to the bosses. today already i am writing them a new email. it reads as follows. it's the follow up to the dialysis saga. i leave july 9th.. we'll see how many more there will be.

Hola amigos,
Last night Doogs told me Vaca Diez decided dialysis patient needs dialysis up until she leaves. Plan last night was dialysis sessions this week (however many needed) and from there we buy her a plane ticket. If I understand correctly she had hongos (fungus) in her catheter and the dialysis last week was not effective.

I just talked to patient (she answered the phone) and patient's daughter. Liliana told me her mom has changed her mind about the Argentina plan. She doesn't want to go. Even if this means her death, she wishes to die at home with her family around her.

Please let me know if there is anything else we can do for her, to meet her wishes and help her be comfortable if that is possible. I'll catch Doogs in the morning and follow up with the fam depending on what he says.

ps. I plan to go visit the patient in her home next Sunday.

alright i've learned to do good things. but all along i've learned the foundation. the foundation never admits defeat. the foundation doesnt believe in boundaries or limits. the foundation thinks that helicopters are the answer to road blocks and argentina is the answer to a failing kidney we cant transplant and a failing body we cant afford to dialize. since i've been here the foundation has never once engaged a palliative care conversation. i just learned this word so i'm probably pretty valiant to be the one starting it. however, i hear what the patient is saying. for the very least, that's why i'm here.

1.5 months ago this is the patient that broke me. i wanted to help the patient survive. now i'd be equally honored to help her meet her wishes.


The Neither Party said...

Life is strange, isn't it? How sometimes while seeking one thing, one finds another?
Could it be you have found a future in palliative care?
I know little about it other than: My mother died of cancer, and palliative care made her passing bearable--even at times enjoyable-- for her and for those of us who cared for and loved her; that the people who work in that field have some of the most difficult jobs on this planet; that the ones I know are caring, compassionate people who deeply understand things about life and death that many in the medical profession clearly do not understand or are not able to force themselves to accept.
Whatever you decide, I wish you well. You are a beautifully compassionate person who I am privileged to know of, if only through your writings here.
Best wishes to you,,,John

Christian Sinclair, MD said...

Stumbled across your blog when I was searching for a 'palliative care'.

You have a very good understanding of what palliative care is. I like to think about it as advocacy for the person not just 'a patient.' The nice thing is that even if someone wants to really fight you can still be involved and be their advocate/supporter.

Even though you may not be going to medical school you may find Pallimed to be a good resource for all things palliative care. You don't necessarily need to know the medicine part of things to practice at least some of the principles of palliative care. One of the most important tools are your ears.