So my last post was so boring, I even bored myself.

On my first day of geriatrics hospice, I got so mad I almost posted. I remember my own family's experience with hospice, and when the hospice representatives were making such a show about hospice easing the suffering of the patient and the family and being such a noble cause...I was glaring so much that I started staring at a wall and doodling on my paper just so the nurse that was speaking wouldn't be cursed by my laser eyes.

Hospice is a good program, don't get me wrong. I support hospice. But it is for-profit, and the people that work for the hospice companies are in paid positions. And while it may be a challenging job, it is *not* as challenging as being the family member sitting there, watching your relative die. It's a job, and when you go home, the caregivers are still at their loved one's bedsides. You're not. You are sleeping in your bed, enjoying your family, spending money you earned at your job on time spent together. That's the way it should be. But you are not suffering...they are. You knew the job you were getting into, helping people die with honor (hopefully). You were never trying to cure them, because they were always beyond that point once they became your charges. You weren't there when the doctor said the patient was cured. You weren't there when the cancer came back. You weren't there when they made the decision to stop dialysis.

When you're talking about your job with hospice, don't start laughing. You don't know who in your audience has had experience with hospice...even if we are health professionals. We're people, too, with lives outside of medicine.

* * * * *

Let me tell you about one of my patients. Cutest little man. Elderly. His wife was there with him. They were so adorable together. I'd ask about his appetite. "Oh, I can hardly eat anything anymore, even my favorite foods!...just a few spoonfuls." "You don't even eat that much!"

Sleep: "Oh, I hardly get any sleep! I wake up every hour, because the pain in my hip and lower back wakes me up at night!" "Yeah, he only sleeps two hours at a time." "I only sleep for one hour!" "Oh, really...?"

Night sweats: "Oh yeah, I have those." "He does, my lord." "But I asked the doctors about it, and they said it's cuz of my medicines."

Weight loss: "Oh yeah, I've been losing a lot of weight. But I haven't had any appetite! Can I drink Ensure, doctor? I think I need to eat more, because I just don't have any energy!"

You're blood sugar sure is low. I think we need to cut back on your insulin. "I told him he needed to cut back on that, but he wouldn't listen to me!" "Yeah, yeah, you know everything." "mm-hmm!" "She's my drill sergeant."

Patient with a history of prostate cancer and colon cancer. For those medically oriented...I'm just positive one or both has recurred. Bone mets are likely with the severe bone pain that is nonresponsive to medications and waking him up at night. 10+ pound weight loss in three months. No appetite. Night sweats. Doubtful he'll survive it if - or when - they discover it has recurred.

He is the cutest little man. And is wife is simply adorable.