Family Medicine Vital Signs

By Anna Stomberg, MD

Brainstorming on what captivating topic I could share with the “family medicine blog” I went through a number of ideas, such as “what would truly express what being a family medicine physician meant to me?”  I wanted something earth-shattering, gripping, a story of rushing in to do emergent CPR, but… when it came down to it, the “earth-shattering” stories are not what stood out as the most influential part of my journey through medicine.  It wasn’t until I was on the inpatient family medicine service recently, walking a family through end of life care and hospice, that I discovered how my perspective on medicine had changed from when I first began pursuing it as a career.

Growing up, I regarded being a doctor as being someone who can save a life in a near death situation, allowing people to stay alive longer. Breathe longer.  Have a heart beat longer.   I never pictured myself explaining the process of death and letting go as a practicing physician, let alone view it in a positive light.  How was this “saving someone”?

On the family medicine service I found out how this situation truly played out as I faced the difficult discussion of hospice care with a patients family – a situation I at one time dreaded.

Bringing up the topic of hospice and process of dying was new for me.  As a resident physician typically focused on “fixing” and “treating” various disease processes, I had to change my tune from the inpatient routine of diagnosis and medical intervention to one of empathy and support.

I pulled up a stool next to my patient’s husband at the bedside and we gently brought up the shattering, but inevitable word “hospice.”  The husband’s eyes filled with tears as reality set in of what he already knew his wife wanted – she was tired, and her body was done fighting.  Even though her vitals remained stable on a polypharmacy of medical support, the truth was she had lost what her life meant to her weeks ago – outside of a beating heart.  Months of dismal nights in a hospital room with monitors had become the norm to a lady whose life had previously been filled with adventure and love of the outdoors.

It was in this moment, and discussion with the family, that I realized how remarkable it is to be a physician that can be with patients and families through the process of living, but also the process of letting go.  In both this patient’s experience and in my family, hospice has provided a solace from the cold and unfamiliar atmosphere of a hospital and allowed patients to return home to where they created a lifetime of memories.  As a physician I am no longer fearful of bringing up the discussion of death and dying, but thankful for hospice so that I can assist families and patients in the transition from fear of the unknown, to comfort in the end of life.

Anna Stomberg, MD is a first year family medicine resident in the Department of Family & Preventive Medicine at the University of Utah, School of Medicine.