A Good Death: The beauty in patients passing on their own terms – February 1, 2017
By Dr. Leigh Johnson, MD
I clearly remember the patient who taught me what it means to die with dignity. He was an elderly gentleman, a veteran and a widower. I’d taken care of him several times already in my short year and a half as a resident. He was admitted frequently with exacerbations of his congestive heart failure and chronic kidney disease, and taking care of his delicate fluid balance had taught me far more than any textbook ever could. He was always soft-spoken and pleasant; unlike many other patients, he never complained and was always compliant with our recommendations. As much as I hated him being sick, I never minded going to round on him, and after awhile I knew his medications, baseline labs, and typical hospital course by heart.
As his health declined, his inpatient stays became more frequent. Finally, he was admitted to the ICU with a particularly bad exacerbation. As usual, his clinical picture turned around in a few days. But this time, something was different. One day, I went in to check on Mr. S. and he told me he was going home. I knew immediately what he meant. I sat down next to his bed and asked him to tell me more. He spoke of being ready to join his wife, who had died a dozen years prior. She was buried in Georgia, he said, and he would be like to be buried there as well. He simply said he knew we weren’t going to be able to “fix” his heart, and he was tired of being in the hospital. He’d like to go home, he said, and be with his family in his last days.
His daughter and son in law had come to the hospital that day, which was rare and in fact the first time I’d met his family members, as they lived out of state. They pulled me aside as I came out of his room and smiled through tears, thanking me for caring for their dad and echoing his wishes to leave the hospital. I cried a little when I spoke to them, and much more when I was alone later. I cry now as I write these words, not out of sadness, but out of gratitude for this family’s open and honest conversation about how life should end, and how lucky Mr. S was to be given the choice to leave this world on his own terms. His family mentioned me in his obituary, which meant more to me than they’ll ever know.
If a career in medicine has taught me one thing, it’s that we as healthcare providers often do too much rather than too little. Our bodies are fallible and broken; they’re designed for a finite existence. Mr. S knew that, and he accepted it with grace, peace, and courage. I think of him often and say a silent prayer of thanks for the lessons he taught me. I know he is with his wife and is happy, and I know I’m a better doctor because of him.
Dr. Johnson is an attending and Associate Professor at the ETSU Family Medicine Residency in Johnson City, TN.