Over the past few months I have spent countless sessions with a patient discussing how he wants to live out the remainder of his life. He is an 85-year-old man with chronic illness, chronic pain, on life-sustaining treatment for the past six years, and a failing heart. A man who has lived his life with such dignity wanted to die with that same dignity he so well deserves. I sat with him weekly as he would share his stories of past work, family life, and deep thoughts surrounding death. He always said he would know when it is time to stop his treatments. He was certain of one thing—he wanted to leave this world with dignity.
Something all too often not spoken about is the loss we as clinicians feel when we no longer see and work with our clients. Whether it be planned palliative care, achievements of goals and treatment plans, relocation or death, we are often so wrapped up in supporting the client and family that we don’t take time to process our own feelings. Quite frankly it feels like it is almost frowned upon if we shed a tear or show our “soft side” as we are supposed to be that strong supporter. However, that client loss is real.
This patient stopped his life-sustaining treatments and transitioned to hospice. He decided to live what was left of his life with dignity—surrounded by his family, in the comfort of his own home. When he called to inform me of his decision I was supportive—commending him for making such a hard decision, but a decision he always said he wanted to make when the time came. Not many people get to choose the way they leave this world, and what an honor for this man to have the ability to make decisions for himself until the very end. He felt at ease, and that was all he needed. We said our goodbyes and hung up the phone.
I closed my office door, took out the tissue box that sits at my desk—for my patients obviously—not for me. I was so happy for this man. This is the dignity he was always talking about, knowing that this was the decision he wanted was comforting—for him, and for me. I cried. I cried because I realized that while I was happy for him, this loss is a loss for me as well.
At 3 p.m. that day, who was going to fit into that gap that I had for so long allotted to him?
I’m so fortunate to work in a profession where I have colleagues I can reach out to. That day I picked up the phone and called a colleague and what she told me will stick with me forever. She said, “You were a gift for this man, but he was a gift for you, too.”
How fortunate was I to have been able to work with him. He gave meaning to my work. He gave purpose to what often feels like “another day at the office.” He made me feel valued. Something we all need in life—that feeling of worth. That feeling of meaning and purpose.
I’m not saying everyone needs to find their dying patient, God forbid. What I am saying is that we all should strive to find that sense of meaning and worth in our lives and in our daily work. Without that, we are bound to live a very bland life. And if you can’t find it—don’t give up. It’s there—as Dory says in “Finding Nemo,” “Just keep swimming.”
Rachel Salamon is a licensed clinical social worker in The Bronx and Westchester. She is the lead social worker for a dialysis company in the Bronx and also provides individual and group therapy to clients with various mental health concerns. Rachel works with clients on implementing behavior modifications to improve overall mental health. She is currently completing training in parent child interaction therapy (PCIT). Rachel is accepting new clients and can be reached at [email protected]
