As clinicians, we have an opportunity to coach our patients during their most significant and vulnerable moments. Our job in healthcare and medicine is to enable well-being; and well-being is the reason one wishes to be alive (Gawande, 2014). It is important that people be able to look at their lives in order to ask the big questions and determine how they want to live.
Clinicians can ask: What is your understanding of the situation and it's potential outcomes? What are your fears and what are your hopes? What are the trade offs you are willing/not willing to make? What is the best course of action that best serves this understanding?
“What man actually needs is not a tensionless state but rather the striving and struggling for some goal worthy of him. What he needs is not the discharge of tension at any cost, but the call of a potential meaning waiting to be fulfilled by him.” (Victor Frankl)
Oliver Sacks noted that it is not only medicine that is needed in one’s declining years, but a life with meaning, a life as rich and full as possible. After he learned that he had terminal cancer, he reported “It is up to me now to choose how to live out the months that remain to me. I have to live in the richest, deepest, most productive way I can.”
"If we wish to know about a man, we ask 'what is his story -- his real, inmost story?' -- for each of us is a biography, a story” (Sacks,1985) By helping patients write their own stories, we can help optimize their self-perceptions and identify obstacles; in so doing we will enable well-being of both our patients and ourselves.
Gawande, Atul (2014) Being Mortal: Medicine and What Matters in the End
Gawande, Atul (2008) Better: A Surgeon's Notes on Performance. Henry Holt and Co..
Frankl, Viktor E. (1963) Man’s Search for Meaning, Washington Square Press, Simon and Schuster, New York, 1963.
Sacks, Oliver (1985) ”The Man Who Mistook His Wife for a Hat.”