3 Fundamental Principles I’ve Learned While Working in Hospice
By Monisha Pujari, MD
Working in hospice is the great teacher. In my time at Hospice Atlanta, I have learned a number of things. Here are three fundamental principles which help guide me.
- Death is hard work:
Most people fear death. They mistrust it, shun it as an enemy. Death is seen as a foreign entity incompatible with life. But that is far from the truth. Death, like birth, is a key component of the cycle of life. As with any part of the cycle of existence, from creation to dissipation, it needs to be viewed as a transformation. Death is not an anomaly; it is a transformation and transformations are hard. Transformations entail literal changing of one’s physical, mental, and spiritual state. They require deep energy and time to process. Therefore, in viewing dying as such, it’s important to consider the next principle.
- Administer compassion by cutting people some slack:
It doesn’t matter if our patients don’t get everything perfectly. It doesn’t matter if they don’t comply exactly with what you think they need. They are going through a challenging transformation which requires their full focus. We clinical providers, supporting them in this process, need to meet them where they are without passing judgment. There should be no other measure of dying than trying to achieve peace. This brings up the final principle.
- Aim for the unconditional:
We are all truly faces of the divine and all carry some spark of divinity, of the universe, of the Big Bang in us, no matter our illnesses, no matter our choices, no matter our minds. It isn’t easy to fully embrace this concept because there is so much pain in the world perpetrated by our choice. But it is still an undeniable truth that we literally emanated from the universe, and within that, there is divinity, whether cultivated and expressed or not. Within that is our salvation. So that is what we need to try to remember when we assist with the final transformation of dying. We need to remember our collective connection to the divine and respect it to the best of our ability. Doing so is aiming for unconditional compassion, which at the irreversible juncture of death is a powerful gift.
Dr. Pujari is a practicing Hospice and Palliative Care physician who enjoys writing about the varied facets of palliative care.