Back to basics

Posted by , 23 May 2018

“The meaning of life is to find your gift. The purpose of life is to give it away.”

With perhaps the exception of the sunrise and sunset, there is nothing more basic than birth and death. Every second of every minute, every day of every year, as the sun rises and sets, there is someone in the world being born – and someone in the world dying.

We greet birth with joy, we advertise it with photos and social media posts, we talk about it and celebrate it and watch people’s faces light up when they see a new baby. The other surety, death, is for the most part a private, secret event that is hidden from the public eye, the topic is pushed aside, avoided, rarely discussed, and sometimes people even cross the street to avoid talking to someone who they know is dying (or worse still, they avoid loved ones of someone who has just died).

I am a palliative care nurse practitioner. Every day of the week I spend most of my day talking about life – the meaning of quality of life, what is important in people’s lives, and what we need to do to help people to manage symptoms from chronic and life limiting illnesses so that life is as good as it could be.

This is my glass half-full description about what I do on a daily basis.

If I was a glass half-empty kind of person, I would say that every day of the week I spend most of my day talking about death – trying to normalise what has somehow become a medicalised phenomenon, explaining the physical dying process, helping nurses, carers and families to recognise deterioration and dying, working with people to help them come to terms with their imminent grief and loss, and assessing and planning for good symptom control to allow people to die peacefully and with dignity in the way they choose to die. That’s the big picture stuff. The rest of the time I feel like I just talk about poo – how often, how difficult, how runny, how hard, and ultimately how to make it happen.

There are many people who have tougher jobs than me. Emergency response workers such as police, fire brigade and ambulance officers have to deal with traumatic injuries and deaths on a very regular basis. They are the first responders, the life-savers, and often the bearers of bad news. Emergency department and intensive care nurses and doctors all have tough jobs and break bad news daily. At least in my job, even though I am often the bearer of bad news, I have the luxury of being able to spend time with people, get to know them and find out what is important to them, and to help with the transition between life and death.

Death, and the weeks and days prior to it, can be such a special time. If death is predicted, it gives people time to prepare, time to say all of the important things that have previously been left unsaid, time to narrow the focus from the everyday busyness of life and the broader community to what is most important to them – usually family and close friends.

In the last few weeks I’ve been challenged to think about the things that are important to me and my own mortality while caring for a very much loved family member. There is nothing more confronting than the death of a loved one, especially someone close to your own age, and it makes you reassess your priorities. While it has been – and still is – an emotional roller coaster, it was also nice to get back to the basics of day to day hands-on nursing care: toileting, giving medications, bed baths and providing reassurance and supporting other family members. I’ve remembered just how tiring it is to be at the bedside of someone you love, watching them breath, waiting for them to stop breathing, wishing it would happen quickly and peacefully, but at the same time also wishing it would not happen at all. It is utterly exhausting, but such a privilege, to be able to be with someone in their last days/hours/minutes/seconds of life. With death comes relief…then the guilt at feeling relief…then anger at unfairness of it all…and eventually some level of acceptance and peace that allows us to move on and continue to live without the person we loved and cherished.

People ask me often how I can do the job I do. I always fumble a bit, mutter something about it being a privilege to be able to help those in need (which is absolutely true), but at the same time I feel totally embarrassed about being put on some sort of pedestal for doing a job that I love doing. Picasso said ‘The meaning of life is to find your gift. The purpose of life is to give it away’. I have discovered, albeit a little late, what my gift is. I hope that in giving it away, I can help others to normalize and cope with death, and therefore fulfill my purpose in life.

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