Preparing For Peace At The End Of Life: Part One

5-6-2016 10-51-36 AMThis is the title of a presentation coming to Athens State University on May 10, 2016 at 11:30am. In it, Dr. Monica Williams-Murphy will use her unique sense of humor to entertain you as you listen to her lecture on death and dying. I know you might think that sounds morbid, but humor is the key to many stressful situations in life, and the death and dying process is no different.

Dr. Murphy is the author of “It’s OK to Die,” and a board certified Emergency Medicine doctor. She currently practices at Huntsville Hospital, where I met her in October of 2014. She attended medical school at the University of South Alabama, and completed her ER residency at the University of Virginia’s Charlottesville campus. As we were talking about her upcoming presentation, I asked her why she went into emergency medicine, especially given how gifted she is in the area of death, dying, and grief. She told me she had always wanted to be a doctor, and that she had considered oncology, but found that she had no desire for the pace. It also didn’t fit her personality, which is always on the go. She doesn’t slow down, and I’ve seen that in action on more than one occasion. She told me she had read the works of Elizabeth Kubler- Ross (a famous Swiss-American psychiatrist and pioneer in the study of death and dying) prior to going to medical school, and it resonated with her.

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She knew there weren’t enough doctors out there talking about the hard things like death and dying, and since she’s never been one to shy away from difficult topics that others aren’t comfortable talking about. She figured if “someone has to do it, why not me?” Emergency medicine also fit because every person who comes into the ER that is truly sick is in a time of crisis and transition, and she knew that she was called to that. Also unique to Dr. Murphy is that she can take these difficult topics and talk about them in a non-threating manner, and still be emotionally present. She’s not the type of doctor who breaks the news that your loved one is dead or near death, and then walks away. She takes the time to sit with patients and families, answers all their questions, and connects with them on a deeper level. In the ER, there is a “joke” that if Dr. Murphy is working, you can pretty much bet that there will be at least one case where you can see her in action, working her own special magic.

One of the things that she will be discussing at the event, which will be a community luncheon held in the Athens State University Ballroom, is the importance of a plan for end of life care. One thing that she believes to be instrumental is talking about your wishes before the issue ever arises so that there is no question of what you want if they do. She is passionate about educating people regarding the different types of advanced care plans and end of life care options. We talked about how to create these documents and what they entail.

I asked her about the difference between palliative care and hospice care. She told me that they are basically two sides of the same coin in that hospice is holistic management of a disease in its final stages (typically the final 6 months), whereas palliative care is for any person anywhere on the continuum of chronic and/or terminal disease. It includes more than just medications, although they are a part of the process as well. Palliative care focuses on the emotional, family interactions, and spiritual care of all involved in the process, especially the patient.

I asked her why someone my age would want an advanced directive, why that would be important. Her passionate response was “Anything can happen to anyone at any time; 10% of Americans die unexpectedly. You don’t want to displace the decisions for your care to someone else without having informed them of what you would want. Make those decisions for yourself, so they don’t have to.” She also told me that it is important to have these documents on file with yourself, your surrogate decision maker(s), and in your electronic medical record at your physician’s office.

“What a different world we might have if doctors weren’t afraid to talk about death, if we had these conversations annually, right along with your routine physical,” she said. But we don’t have those conversations, partially because we aren’t trained to handle it well. And the media doesn’t help; instead TV shows like House, Grey’s Anatomy, and Code Black portray medicine as miraculous and glamorous. In reality, it’s anything but. “As nurses and doctors, it’s our job to lovingly lower the expectations at the end of life if the miracle doesn’t happen,” she told me.

I encourage you to register for the free event as soon as possible given that seating is limited to 200 people. You can register by calling 256-233-9122. Come and hear Dr. Murphy speak as only she can about how to prepare for peace at the end of life. You won’t be disappointed; you might even be delighted.
By: Rachel Clark, RN, BSN