I was going to need more coffee—I hated nursing homes. Not that I disliked old folks; in fact, I really loved taking care of the elderly. My aversion to the “homes” stemmed from seeing how the souls that roamed their halls (or sat in their rooms) seemed so drained of the energy and vivacity they used to share with their loved ones. I hated picturing how somebody’s Grandpa, someone who used to tell his grandchildren stories and sneak them Snickers bars, was now in a place that in no way resembled his home and that rather served only to drain him of his livelihood while simultaneously preserving his physical life.
Don’t even get me started on the dying aspect. If there was anything I was more uncomfortable about than the actual nursing home, it was the dying going on within its walls. Needless to say, I was less than thrilled to step into my first day in the Kate B. Reynolds Hospice Home. Equally needless to say, I couldn’t have been more wrong in what I was expecting, nor was I prepared for the growth that I would experience.
When I came into my hospice experience, my ignorance led me to envision a place that showcased all of the grimness of a nursing home with even more dying. In all honesty, I even thought that a physician must have to be just a little off-kilter to want to work in hospice as a career. Luckily, my perspectives and prejudices were changed (or, shall we say, matured) by the time I moved on from hospice.
Most clearly, hospice is not a nursing home. Dispelling this misconception was the easy part. I was instantly struck by a feeling of calm when I walked into KBR for the first time; there was a sort of yoga-studio-meets-hunting-lodge atmosphere that was nothing like the cinderblock corridors I was expecting. Conspicuously absent were the code carts, telemetry boxes, and those mesh hospital chairs that have never been and will never be comfortable; in their place were bookcases, vanities, and sitting apparatus worthy of being called chairs. While all of the topical pleasantries disarmed my early fears, I was still skeptical about the dying aspect of hospice. I was completely unprepared for what I would learn.
When I think about my hospice experience, I think my most valuable insight was learning that for many people, dying is like their first kiss; they spend so much time worrying that the setting, timing, and atmosphere are just right that the kiss itself is something of an afterthought. I saw that dying was not nearly as scary as living in pain, isolation, and dependence. For many folks, death meant a lot of things—a chance to reunite with a spouse, a chance to make amends with estranged family members, and an opportunity to find out what happens next. I learned that dying with dignity and on one’s own terms could be much more valuable than living without quality of life; and I began to see why docs would choose this as a career path.
In all, I learned a lot more in three weeks at KBR than I could have possibly expected. I learned how much compassion and planning can go into a person’s end-of-life care, and I learned not to always look at death as a treatment failure, but as an integral part of life that should be provided with as much compassion and dignity as possible.