|There comes a time when a patient has a terminal
diagnosis, when as a physician you know there is nothing more you can do
to help stop the disease process. All of the technical skills and modern
medicine can only help to make a person more comfortable.
We are taught in medical school to view death a failure and will go through a denial and bargaining phase..."If only I had ordered another test, started a different antibiotic, if only the patient had less extensive injuries, or had gotten to us sooner, if only..."
What I realized early on in my career, is that as physicians we are not invincible, or infallible. There are times when a test, a study, or an x-ray no longer make a difference. What makes the difference is having the time to just be, to hold a hand and give support. This is a lesson that I have learned many times over from the patients I have treated on Hospice. Their strength and courage has taught me that often the most difficult role of a physician is knowing when to "let go," and just "to be."
the ancient covenant between physician and patient
a promise to cure,
and to restore.
Healing appears in many forms--
But what of the terminal diagnosis
Healing becomes an expression
of caring and love.
Kirsti A. Dyer, MD, MS