Thursday, November 17, 2011

What really matters .....

This week i heard Rabba Sara Hurwitz speak, and for those who may not know she is the first ordained woman Jewish Orthodox Rabba (or Rabbi). It may be hard to imagine the tumult her "conferral" (or ordination) has caused, but in this Blog i want to focus on something she said that really hit home as a Hospice physician.

For all the dispute over what it means to have a Jewish Orthodox Rabbi, and i understand that may not matter for many people, certain things are clear, that Rabba Hurwitz has worked extremely hard, she is extremely bright, and she has not simply learned "just as much" as a man seeking to be a Rabbi - she is a gifted and learned human being. But in talking about being a Rabbi, the day to day stuff, it really hit home when she said, "the most important thing is really .....showing up --- being present for people."

For a physician that may often be the case. Yes - we train hard and work hard, and dream of saving lives, but when a patient has an incurable illness - "being present" can be the most important thing.

Rabba Hurwitz talked about counseling a married couple in trouble, and she talked about being present for a holocaust survivor who lost her son in an accident, and shortly thereafter lost her husband. And i think to how often i have seen patients who could not be cured, but simply wanted their doctor to care for them - care about them - just be present.

Somehow - they view us as knowledgeable in life cycle events, little do they know in medical school and residency how little is taught about dealing with feelings - it isn't a question "on the boards." How much more joy in quoting the most recent article in "rounds," or in making an astonishing diagnosis - and yet -- sometimes people are so willing to forgive us for so much - if we can just be present. The fact that we can't cure someone doesn't mean that we can't care for them.

I must admit as a Hospice doctor - there are these joyous incredible moments when i make a diagnosis everyone else has missed, and cause the turn around of a severe illness and actually discharge a patient from Hospice. Yes - it does happen. It is like hitting "the shot" in game 7 of the NBA finals or hitting a 9th inning home run, but it doesn't happen that often. Most days - i come to work, and not being able to cure anyone under my care, i continue to care for them, and most importantly be present with them --- as so many people have said to me "I wish they wouldn't treat me as if i'm dead already, I may be terminally ill but for now I'm still living."

I went to hear a speaker talk about what it meant to be the first woman Rabbi, and what i really took home was a reflection on what was the most important thing in my own job - yes I bring hard work and long years of study, but so often for the people who come to me the most important thing is that I showed up, and that for them - for that moment, I was "present," and that even though I couldn't cure them I could still care for them and share the moment with them.

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