Living up to expectations

Well, I've finished my first week of palliative care and it was as good as I expected. What's good about it? Here goes:

• A truly interdisciplinary team made up of a spiritual care counsellor, psycho-social counsellors, social workers, nurses, and physicians who really seem to care about each other and all the patients (even the difficult ones).
• The moments during the interdisciplinary rounds in which the names of the people who passed the previous week are read out and everyone is reminded of the important work they do and the people whose lives they touch.
• The focus on quality of life vs quantity of life, healing vs curing.
• The physician I was with who, after a family meeting that didn't go as he had planned, was reflective aloud about this own reaction to some aggressive family members and what he might have said differently to be more effective, and in his words, less defensive. (Sadly it seems that reflection can be all too rare in medicine.)
• A random discussion that sprung up around the charting table about how the various health care practitioners and staff are able to continue to do this work, i.e. how they nourish their own spirit and replenish themselves.
• The homelike atmosphere which really is filled with love, by the end of the week it felt more like a guest home than a hospital ward- like we are hosting people vs treating patients. The food brought in by volunteers, the music (there was harp being played in the lounge one day this week, and bedside singing another day), handmade quilts on people's beds, a staff room where people eat altogether. A sense of collegiality and cohesiveness that I simply haven't seen elsewhere.
• The rewards. I was delighted to hear the physician I was with this week say something I have said to quite a number of people in the last few months, that it's the people not the disease that make medicine so interesting. (At least to me, and obviously to him too!)
• The focus on good communication with patients and families as critical to the practice of palliative medicine - about sometimes difficult topics, like prognosis and treatment options.

In summary, I like it and I think it likes me. Might be the makings of a long term relationship, we'll see.