Many people ask me what my most important task is. Without question, it is helping people die with dignity, in comfort and surrounded by those they love. I was reminded of this as I paid my last visit to a patient who had touched me greatly. As I watched her navigate her final months and days with peace and fortitude, this brave and dignified woman taught me more about life than I could ever convey.
I first met her six months before her death, when she came to see me complaining of progressive weakness in her arms and legs. It did not take us long to make a diagnosis. She had amyotrophic lateral sclerosis, known as ALS or Lou Gehrig’s disease, a devastating illness with a very poor prognosis.
Upon first meeting her, I quickly realized that this was a truly remarkable woman with whom I would develop a deep connection. She was beloved by many friends and blessed with a loving and devoted family.
As she faced the reality of her illness, her first concern was becoming a “burden” to her family. This is a concern that I frequently hear but one I cannot always understand. After all, if you can’t depend on your family, on whom can you depend? After much persuasion, she finally acquiesced and agreed to move in with her daughter. With the help of her brother, husband and children, her daughter spent the next few months caring for her mother, who rapidly became more and more paralyzed. Far from being burdened, her daughter tells me that having her mother move in with her was the best gift her mother could have ever given. The closeness made her appreciate her mother’s caring nature, her brilliance and her attitude toward both life and death. The entire experience was viewed not as a burden but as a unique privilege that will always be cherished.
Soon the patient could not turn in bed without assistance. It took two strong people to move her from the bed to a chair. With steely determination, she finally insisted that continuing to live with her daughter was something she was no longer willing to do. After a short time in a nursing home, she was persuaded to enter an inpatient hospice unit, where the staff is uniquely trained in comfort and end-of-life care. The goal was not to prolong her life but to ensure that her remaining days were comfortable, peaceful and with all the spiritual, social and family support she needed. The care she received there was truly exceptional.
I spent a great deal of time sitting with her, discussing her illness, her imminent death and her thoughts and concerns about them. Throughout our conversations, it was clear that she was at peace, maintained a strong faith and had no fear of dying. Her concerns were only for her loving family members. She tried her best to eat, not for herself but for them. At one point, she asked me — with tears in her eyes — whether she could stop eating. Her family members spent hours helping her swallow food, which was already difficult for her, and she was concerned that not eating would upset them. “Of course it is OK not to eat,” I told her. I promised to tell her family, who, with solemn understanding, agreed with her decision.
From then on, she did not suffer. Still able to communicate, she made peace with those who loved her and retained her dignity throughout. As I said my goodbyes, I knew I would grieve deeply for her. I will always remember her, knowing with certainty that helping her and others like her die is the most important spiritual and professional task I can ever achieve. Her story should be a lesson to everyone, young and old alike. Death is as natural as birth, a continuation of the circle of life. No one wants to spend the final days in a hospital and hooked up to machines. Whenever possible, a dignified and comfortable death means a much better life for everyone. My patient has gone in peace, always remembered by the many who deeply loved and respected her.
Dr. David Lipschitz is the director of the Dr. David Health and Wellness Center in Little Rock. To find out more about Dr. David Lipschitz, visit www.drdavidhealth.com