Bad job.

Today was awesome.

But sometimes on awesome days, I have my off moments. I still have moments when I feel overwhelmed with guilt at work. It is horrible to watch people die. Death is part of life, and it certain proceeds illness at times, but that doesn’t make it easier to make a dying person do exercises. I have moments when I need a coworker or a self-ass-kicking to remind me that even dying people need help.

Sometimes I can sense that someone is dying before they or their family can. Nobody sends a note to me that says “Mister J is knocking on death’s door.” I am intimately involved in the way they function day to day, and when that begins to decline drastically, I just know. I know exactly how their body is failing in some cases because I’ve studied their medical history. It’s especially heartbreaking when someone’s mind is still working and I continue to build a relationship with this person. I still make them laugh, listen to their stories, and hold their hands when they are scared or crying. It’s a crazy and complicated balance to know and do all of this with some semblance of professionalism. There are parts of me that just want to tell them to go to bed and have a nice rest.

I have an integral part of me that uses guilt as a default emotion for everything that is confusing or hard to describe goes. It pisses me off.

When people are slowly dying, they are in pain. They are easily fatigued. They have shortness of breath and their vital signs can be erratic. I have to help dying people keep active, to do the best they can and have the very highest quality of life possible before it’s time to give-up. In most cases, I feel horrible about this. I don’t want to put them through pain and discomfort day after day, just for the sake of keeping them alive. But who the fuck am I to decide anything other than how to treat my patient during the thirty minutes they are my responsibility?

There is no neat and tiny conclusion to this thought. I cycle through this conversation with myself regularly, trying to process the guilt and empathy I feel, and inevitably stop myself at “Who the fuck are you?”