Working at Hospice

So this semester I've been doing one of my internship rotations at the San Diego Hospice. I knew it would be difficult, but it's been much, much more difficult than I anticipated. My supervisors are great, and I'm so happy for the opportunity and the growth. It's been one of the clearest examples of patients-as-teachers that I've ever experienced. I knew I wanted to do this shift as soon as I got to San Diego and found out about it, and I do not regret my choice. But yowza, is it ever hard work keeping my head above water some days. I mostly think of myself as pretty tough and resilient, but sometimes I guess I come awfully close to biting off more than I can chew.

Still, it's been a fantastic learning experience--both about the medicine I've chosen to practice, and about myself. I'm not always as tough as I want to believe that I am--I'm also not always as empathic as I like to think I am. As often as I am taken aback by the stomach-socking sorrow, love, fear, and sympathy that comes hollering up between me and a patient, I am surprised by the boundaries I erect and the attachments I don't form.

I miss my mother. I'm finding that part of the reason I think I signed up for this shift was that I hoped somehow I would find her at Hospice. I thought maybe some sort of connection, some message from her, would turn up there. It's such a ridiculous oversimplification, I see now, reducing her whole self and her whole life to the weeks in which she was dying.

But then again, I look for her everywhere. Maybe at Hospice it made sense that she might be closer, in a place where the twilight connection between life and death is less fuzzed than we manage to make it nearly everwhere else. And she is there and she isn't, just as she is and isn't everywhere else. It breaks my heart that my relationship with her won't evolve any further than where it was when I was a difficult and confused teenager, and I watch us grow together into an adult relationship that I don't know how to relate to the other parent-and-child relationships I see growing around me.

There are multiple lessons here, I know. At least one big one. I'm not sure what it is yet. Today I found out that a patient that I had been treating at Hospice died over the weekend. It was expected, of course. She was the same age my mother was when she died; like my mother, she wore red lipstick in her bed and lay among the humming machines and hospital linens like a tiny, jaundiced queen, gracious and imperious all at once. I wanted something from this patient that it was not her place to give me. I wanted forgiveness, I wanted to be allowed to effect the miracle of healing her. When I learned she had died I wanted to grieve her death in a way that felt natural and visceral and feel a sense of relief when I was done. What I did instead was swallow and do my paperwork and visit with other patients, and feel alternately ashamed of how selfish my own sense of loss is and disturbed by how disconnected I felt from the patient's death.

The engagement ring I'm wearing has a red stone; it's the favorite color my mother and I shared. She would have loved that my lovely fiance gave me a custom-designed ring. He proposed to me the weekend of Mother's Day so that I would feel like it was something I could share with her. She would have loved him; I dreamed of her smiling and radiant in his chair. I can't believe that she isn't with me all the time, and I can't stop trying to get closer to her either.