Friday, August 19, 2016

Walking the Walk — Moving On

By Ana Leech, MD
Houston Palliative Care and Hospice Physician
Medical Director, Memorial Hermann Hospice IPU
Medical Director of Palliative Medicine, Memorial Hermann Southwest

Editor’s Note: Physician Ana Leech, MD, shares her family’s experience caring for her father, who had a terminal illness. As a hospice and palliative medicine physician, Dr. Leech is able to tell her story from both a personal and medical professional perspective. This is the fourth and final part in a series. Read parts one, two, and three.

He is gone. I gave him one more kiss and now he is gone. I will never be able to see my father again, put my arm around his back or watch him make silly faces with his dentures.

I feel honored and privileged to have been the medical point of contact. Somehow I had the opportunity to understand what was going on better than the other members of my family. As both his daughter and a palliative care and hospice physician, I had access to information and a level of understanding that no one else did. I knew what was going on more than the other doctors because they don't routinely care for patients at the end of life (and don’t like to acknowledge it when they do), and I knew more than my family because I had more medical information. I think this is one of the most special privileges doctors have, and this time it means a lot more because it gave me a special bond with my dad during his dying process. I feel that I started to process his death the day I saw the MRI images. After looking at those images and reviewing them with colleagues, I appreciated every time I saw him from that point forward as the true gift that it was.

I am grateful that I had the insight and training to do some legacy work (creating memories and mementos for friends and family to remember a loved one by) when we still had time. I have always had frank discussions with my children, so they seem to be coping well with his death, almost too mature for their age. The kids will always remember driving lessons (at 11 and 14) from him.

It seems like he is gone too soon. He still had plans and things to do, but then again my husband wondered if my dad would have run out of things to do. I feel like I should have spent more time with him — like I didn’t do enough to cherish his life. However, I did so many things with him even when I was young. Those memories will be with me forever.

The first few days after his death were rough. I felt numb. I could not believe I would never see him again. I spent a lot of time with my mom doing nothing; just letting the day go by. I am particularly lucky because all my coworkers are used to comforting people after the death of a loved one, so I have gotten an extra-large dose of love from every one of them.

The hospice team provides 13 months of bereavement support after someone’s death. I am glad they will be there to check in on my mom and one of my sisters and her children. For different reasons, they are all having a hard time with his death, and they can all use the extra support from hospice. If they are still having difficulty after the first year, it is considered complicated grief, and they will be referred for more counseling. I am glad someone else will be making that decision.

He was cremated with no viewing, so getting to closure took some time. He did not want a pompous funeral because he always wanted to be enjoyed while alive. My dad was always a creative guy, so in his honor we tried to reinvent the funeral experience. We had a progressive celebration of life composed of events ranging from the very formal to the very casual to allow everyone to say goodbye. I have always felt that final services are supposed to be about the deceased, not about cultural norms. Surely I learned that from him. His remains were placed in a crypt at the cemetery. We all went out for ice cream afterwards.

As a complete coincidence, about a month after he died, my husband and I went a road trip very similar to those I went on with Dad when I was a child. It was bittersweet, but the experience helped me say goodbye while ensuring he lives on as I pass on to my children what he taught me, and hopefully they will pass it on to their kids.

We live longer when people whose lives we touched remember us. He will always live in my heart.

Dr. Leech is a Houston palliative care and hospice physician. She is medical director at Memorial Hermann Hospice IPU and medical director of palliative medicine at Memorial Hermann Southwest.

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