So interesting… so funny. To see the same problems in Mexico that i see in Canada and that I hear about in other countries. How difficult it is for human beings, including doctors and nurses, to understand, to recognize when death is nearing. How difficult it is for us to put aside our options to intervene and to find out what the patient wants, what is possible for the patient and the family, and then, only then, to offer care options.
Today I met a person who was taking her last breaths, while an order for an xray sat at the end of her bed. Why? What good would this information do? How would the information change the care? How would the family pay for the xray while also paying for the funeral, the transportation of the family to the city where the grandmother was taking her last breaths?
As palliative care specialists it is sometimes easier to recognize when death is approaching, perhaps because we arrive with fresh eyes, or perhaps because we are more familiar with the dying process… or perhaps because we are comfortable discussing goals of care with the patient and their family.
When we think about what we do in palliative care, perhaps we should say, ‘We talk with people about dying”. Rather than suggesting that we help to manage symptoms. Perhaps the most important thing we do is to open the door to conversations. Once the door is open, then we can discuss the other things that are possible.
It is wonderful to be here with Dr. Gustavo Montejo and his great team, including two other doctors, one social worker, one nurse, and many students. I am grateful to learn from them! It is wonderful (and difficult) to see that they are facing the same challenges in their city that we face in our city. This little team provide care for the entire acute care hospital.
Kath
