Steve Hart talks to a doctor who helps people come to terms with dying
It is hard to imagine that helping people come to terms with dying can bring a lot of happiness. But one hospice doctor says the job has more than its share of joy and laughter.
Dr Warrick Jones is the medical director at North Haven Hospice in Whangarei and started to work in hospices shortly after graduating from Otago University.
"The job is so full of joy," he says. "The environment in which I work is full of laughter, it is a very healthy environment. There have been birthday celebrations, wedding anniversaries and even weddings here."
Dr Jones, 42, began working in a hospice part-time to help makes ends meet when he started his GP practice.
"I had started from scratch and needed a regular income to pay the bills and support my family while my general practice got off the ground," he says. "So I took a day each week working at a hospice. The process and the good that can be done in that setting intrigued me.
"It can be an uncomfortable place for a medic to be in though. We know that all of life comes to an end but we don't really get trained to engage in that - to enter into a journey with people. Certainly it didn't happen when I was trained 20 years ago."
While Dr Jones appears to have unconsciously moved from family GP to palliative specialist, he says he can now look back and see when the change in his career started. It was in 1987, the year his father died in an accident.
"This happened while I was still at medical school," he says. "I had learned all about the body, how it works, the anatomy and physiology and what these processes were supposed to be like. And then there was this accident and this incredible feeling of being helpless. I realised that no matter how much information and knowledge I had - you can't stop death.
"It changed how I viewed medicine. It redefined my expectations of the career. When I look back now, I can see how it changed me. I think if people took stock a little bit more about the outcome of life, then the choices they make would be a little bit different."
He says handing out drugs is what he has to do as a doctor, but it is only a small part of working in a hospice.
"People have often trusted themselves to the medical system in the hope of a cure - people don't want to die," he says.
"But in doing that, they can feel fearful and out of control. They have been told, 'Sorry, there is nothing more than can be done for you', and that is probably correct in terms of what those medical providers can offer to that particular patient.
"The patient may have been told that no more surgery is available, no more chemotherapy will help, they can't be made better than it is, that more radiation won't make a difference to them. And in some regards that is a true statement.
"All people hear is, 'Nothing more can be done for you', and they translate that as meaning, 'I can't feel any better than I do now - I have no hope that life can improve in any way'."
Dr Jones has been working in palliative care full-time for eight years and says part of his job is to listen to the fears of people. He believes in informed consent, but also says people should be told just what they need to know to make decisions about their future.
"Helping them is frequently just a case of sitting down and going over their doctor's notes and explaining the whole situation," he says. "Often, people hear the words but they do not know what they mean. And when you sit down for an hour and explain what it all means, and ask them what they see happening, they find making decisions a lot easier."
He says working in hospices has helped him understand some simple things can be done to make the end of someone's life a lot more palatable.
"It isn't a big step from GP to palliative medicine," he says. "As a GP I never cured anyone of anything. I only suggested lifestyle changes and prescribed medicine.
"When people came to me with asthma I could only help them manage it better - even the job of a GP is really the management of illness.
"I thoroughly enjoyed it though. I loved the kids, loved the family medicine, but even then I had stints working with older people and thoroughly enjoyed that spectrum of care too. Even when I started out as a GP I don't think my expectation was to make people well - even though that was how the whole medical system was established."
Dr Jones has worked at the North Haven hospice for six years and says he works to celebrate as much as possible with the staff, patients and their families.
"My goal now is to see people die whole or complete," he says. "They won't die [with the] absence of illness, but they can end this life as a complete person. Not so much in a physical sense - I'm looking at the emotional, the social and the spiritual aspects of who we are."
HOSPICE NZ AWARENESS WEEK
Hospice New Zealand's awareness week runs until May 17 with a campaign called Live Every Moment.
The campaign has been launched to remind people how good it feels to share everyday moments, big or small, with people they care about.
To take part simply visit www.hospice.org.nz. If you're feeling creative start with a blank canvas, adding your choice of images, quotes and words as well as a personal message. If you need a little inspiration there is a selection of ready-made moments to personalise and email to friends.
By sending a moment or passing the link on to friends you will be helping others to understand the philosophy and heart of hospice, enabling people to live every moment.
The 28 hospices around New Zealand are running activities and street collections to raise funds for the free service.
On the web: www.hospice.org.nz
Steve Hart is a freelance writer. Contact him via www.stevehart.co.nz
