Samantha DeMarsha, BS, OMS IV
Ohio University Heritage College of Osteopathic Medicine,
“You’re giving up on my baby!” I could still hear the inconsolable mother shriek in my head as I ran along the Mississippi River under the hot sun. The pediatric oncologist had explained the gravity of the infant’s condition to the family. Her disease had taken its final turn and the care team was out of viable options. Should they push forward with the chemotherapy that her tiny body could no longer handle, or surrender her to this terminal disease?
When I entered medical school, I stood next to my classmates, held up my right hand, and recited the Osteopathic Oath in front of a filled auditorium. A portion of that oath reads, “…I will be mindful always of my great responsibility to preserve the health and the life of my patients…” Yet, within one week of my pediatric palliative care experience, I had witnessed more confrontation with death than in the first twenty-three years of my life combined. I became unsettled about what that brief statement entailed for my future career as a physician.
The image of the baby girl held tightly in her mother’s arms flashed through my mind. Her small body looked frail, but her grave prognosis was not readily apparent. I could still see the glow of life in her eyes juxtaposed against the fear on the faces of her family members. Did she have an awareness of the situation? How could she?
Paradoxically, I thought, tubes and medications are plunged into loved ones daily to keep them close. In many religions, our time on earth is only a fraction of the existence of our soul, so why do we push beyond limits to preserve it here? Conversely, what if there was more you could do for one more good day with your mother, father, child or friend?
With each stride I took, the blue of the sky faded into a radiant hue of orange. How fast this past week had come and gone, I thought. One week seemed miniscule in comparison to the patient’s mother’s age, while disproportionately large to that of her young daughter. I wondered if the time seemed to be passing too slowly or too quickly for the family. In choosing fewer quality days over prolonged quantity, they were to face loss sooner than anticipated, but with comfort as the unifying priority.
One more good day. In medical school, we learn to define the stages of lung cancer, to define progressive nature of heart disease, and we even attempt to define the neurobiological basis of depression. But how do we define a “good” day? Can it be described as a response to treatment, improving vital signs, or even a reduced pain score? Possibly “good” is the point at which medicine leaves the realm of science and becomes art; standing at the point of parity between promoting healing and easing suffering. A human life is fragile, but the human spirit is redeemably strong, be it alive for an hour or a century. Humanism is essential to the goal we set out to achieve when we received a white coat and it is crucial for care in the last few days of life. As I redirected my route towards home, the white moon emerged as the sky darkened.
ACOP 2019 Spring Conference