What I learned from a doctor who works with the dying
Sarah Atkins is a Columbia Med School graduate, who chose a road in medicine less travelled. Instead of saving lives, she followed her passion to supporting the end of life, which we seldom talk about in our society, let alone take into account into how we choose to live.
I met up with Sarah on a sunny hot San Francisco afternoon, and here is what she had to say about life, death and everything in between.
How did you decide to become a palliative doctor?
I worked as a hospice volunteer while growing up, and I valued the privilege you get to be part of the intimate and beautiful process of death. After medical school, the passion of taking care of people in an intimate setting came back to me while I was choosing my specialty.
There is a lot of pressure in medicine, to do more academically challenging specialties, which makes you question yourself. Additionally, working with end of life can be too taxing emotionally.
To me, it was about finding my people. Palliative care had the people I wanted to work with and learn from.
A story of a patient that marked you…
Unlike other type of medicine, spending a lot of time with patients and hearing their stories is part of my job.
I met one of my most favorite patients years ago. He shared with me his life story. A suicide attempt he had, and him finding his way back into a place to love life. After making this long journey, that was hard for him, and being surrounded with people who supported that, he was diagnosed with terminal cancer.
Someone who finally found his passion for life, here it was getting taking from him. That juxtaposition is grappling. I was with him in the transition, he was in his early 40s. I remember when he was very sick, him and his mom, who is a professional dancer, were dancing in the living room. I miss him a lot.
What is your own view on death?
I am around it a lot. All my patients are dying, so death to me is normalized.
Death is not scary to me. It is the loss and the grief that are scary.
I try to reframe grief as an expression of love. Even though it feels very definitive, people keep on going and move on.
I have no idea what happens after death. My sense is nothingness. When you talk to people, everyone has their own belief. It is what you need to believe in order to face it. Wether you are reunited with another person who died, or going to heaven, it helps with facing uncertainty, which is terrifying.
What do you learn from the dying about living?
Gratitude is the biggest one. Which gets expressed in so many different ways. Stating gratitudes towards people and things and being intentional about it.
Laughter, is really healing. Remembering to laugh even when it is awful.
Love. Doctors would not say they love their patients. Everything that families do, and doctors do is an expression of love.
What are the common regrets of the dying?
Most regrets fall into one of these categories:
I love you
I am sorry
Please forgive me
These categories come from an ancient Hawaiian practice of reconciliation and forgiveness, called Hoʻoponopono.
Regrets are usually around family and friends. And not having spent enough time with them.
Another common regret is having hurt someone you love, and are not connected with them anymore.
Advice to someone who does not know their passions, or are not living them
I don’t think if I had to do it over I would be a doctor. There is something to say about creating your passion in your current work, and your current life.