The Last Request
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REFLECTIONS
The Last Request Frederic Ivan L. Ting 1
&
Michael D. San Juan 1
Accepted: 2 October 2020 # American Association for Cancer Education 2020 Abstract This essay is a personal reflection highlighting the importance of spirituality in the care of cancer patients and their families especially at the end-of-life. Keywords Palliative care . End-of-life . Spirituality . Prayer
Manuscript Mrs. V was a 59-year-old mother of three with stage IV pancreatic cancer who was admitted for palliative care. I was running towards her room when I first saw her because she was screaming with excruciating abdominal pain upon admission. When her pain was eventually controlled, I found out that she was a gentle lady with a charming personality. Having been a grade school teacher, she was effortlessly full of joy and enthusiasm. Mrs. V was special because every time I left her room, she always held my hand with both of hers and whispered “Thank you, Doctor. You made me feel better today.” We developed a great relationship throughout the course of her stay. I would see her three to four times a day not only because her pain was waxing and waning, but I also wanted to make sure that she was feeling comfortable and was enjoying the last few days of her life with her family and close friends. Being in the service profession, I find profound joy and meaning in every patient that I encounter and help in one way or another. After mentally checking that I have accomplished all my to-dos regarding their care, I make it a habit to ask if there is anything more I can do for them before leaving. Most of my patients would always answer “Nothing else, Doctor. We’ve covered everything,” but not Mrs. V. From day one, her constant reply to me was “Not today, Doctor. But one day I will. One day.”
* Frederic Ivan L. Ting [email protected] 1
Division of Medical Oncology, Department of Medicine, University of the Philippines—Philippine General Hospital, 1000 Manila, Philippines
Weeks passed by and Mrs. V continued to deteriorate with episodes of excruciating abdominal pain. When we reached the terminal phase of her illness, a family meeting took place to discuss treatment options. Mrs. V decided not to be resuscitated in the event that her vital signs crashed and opted to be sedated if needed to control her pain. We all knew this was coming, and it was just a matter of time. Over the weekend, the resident physician updated me that Mrs. V had to be sedated for pain control. When I visited her the following morning, this once sweet and charming lady was now bedbound, looking comfortable but unconscious, with her respiratory rate going down as an expected side effect of her pain medications. Before I left the room, I held her hand and asked, “Is there anything else I can do for you today, Mrs. V?” Of course, I was not expecting her to be able to reply. But after hearing the question, one of her daughters approached me and gave me a hand-written note that says, “Please pray for me.” With tears falling down her eyes she then told me “Doctor, t
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