Personal encounters of witnessing death often makes the topic of death much more real and close to heart. We know that death happens to everyone, but we never know when and where. In this series of Dielogue, we share the heartfelt personal experiences of a healthcare practitioner, who meets patients near their end of life.
Meet Marilyn Ho, an Advance Care Planning (ACP) Coordinator in Tan Tock Seng Hospital. Her job allows her to meet people and hear about their lives, values and experiences. She facilitates difficult conversations on healthcare and death, and also discusses with people about future healthcare preferences.
“The goal is not ‘getting comfortable with hard conversation’ but ‘normalising discomfort’. It’s very humbling when they trust us and share their life stories with us.”
When did you first join the medical industry as a nurse?
I first joined the healthcare industry as a full time registered nurse in 2012. Tan Tock Seng hospital was where it all started for me. I was initially given a post in the clinic with regular office hours but all I wanted at the point in time was to work around the clock in a general ward. I wanted to change diapers, shower the patients and be on the ground. After weeks of speaking to many people, I finally got a transfer a month later. I was so happy.
While working in a general medicine/cardiovascular ward, I found my passion to be taking care of elderly patients and patients at the end of their lives. While taking care of dying patients and their family, I felt a great sense of pride to be able to be there for them during one of their most vulnerable moments. I’d volunteer to do last office* for patients who passed on. I think it’s an honour to deliver good professional care to the dead and bereaved family. How you respect the deceased makes a lot of difference to the experience of their families, and the experience stays in the memory of the ones who live on.
“We celebrate lives when they arrive in this world. In my opinion, we should celebrate even more when we leave – for the good lives we have created, the people we have crossed path with and the lives we have touched.”
Any specific incidents on the job that changed or left an impact on you?
The first death that I witnessed was an 18-year-old young man who died from drug overdose. I was in my first year of nursing school and I was by his bed when he took his last breath. I was tasked by the staff nurse to keep a look out for this patient and make sure he was comfortable till his family arrived. He was sweating profusely and was breathing in a strange manner that I didn’t understand. I prepared a standing fan for him and screened the curtain, then I held his hand and asked him to hold on while watching his irregular and weak heart rhythm on the screen. His breath became more and more shallow and he passed on before his family arrived. I remember vividly the look on his face at his last breath.
When his family came, I recalled their sadness and his mum fell to knees by his bed. Her anguished cry still rings in my ears when I think about it now. They requested to speak to me as they wanted to know how he was before he left. I was shaken but I told them all. His mum hugged me and we both teared. His last breath was the beginning of my new life. Many other experiences after that changed me progressively.
Patients were my best teachers. One of my ex-patients was a 35-year-old lady with stage 4 breast cancer. When I interviewed her for a research study, she said:
“Marilyn, I wish I were young again and I wish someone told me this – It’s good to have goals in life, but we are sometimes so obsessed with materialistic satisfaction, we squander our money, we waste our time. All the money I have now, buy me no cure and no time, and worst of all, they cannot help to buy my daughters’ memory of their mother. My kids might just grow up not remembering me at all. If I can give you one piece of advice, money is important but it isn’t everything that you should set your mind and eyes on. You need to set your priorities right, live in the present and live right, be nice and be kind.”
That was an ordinary day in July 2016 which completely changed my perspective.
If you had 30 days left to live, what would you do?
If I had 30 days left and I can still walk around, I would want to go for long walks in the nature. I would want to spend some time with myself, reflecting back on my life, finding peace and getting ready for my departure. I will spend time with my family, creating new memories and looking at my childhood pictures. I will hope to have a party too, where I gather all my closest family and friends to celebrate my life, with wine and balloons, and a live band as well. People would be invited to give speeches or deliver eulogies for me. I would wish to listen to them before I die. I would cry, everyone is allowed to cry as well. As Queen Elizabeth II once said – “Grief is the price we pay for love”.
*The last offices, is the care given to a body of a dead person shortly after death has been confirmed.