Is it because we never knew them when we were well?

[mappers]

Recently, my daughter asked me if I ever got sad when patients died. I said yes. She asked me if I ever cried and I said rarely. I told her that usually the patient was so sick by the time they die that it feels almost like a relief that their suffering had ended.

I thought about a couple of recent deaths and realized that I had never known the person when they were well. Both of these patients had been dealing with their illnesses for many years. Even though I knew them over two years, they were still pretty sick by that time, going through 4th and 5th rounds of tx etc.

I struck me that it might not be as sad for me since I had never know them as vibrant healthy people.

[Double-Helix, BSN, RN]

That's definitely possible. Since you've never known them when they were healthy, it's easier to see the death as a relief and harder to see what they have lost. You've only known them to be sick and suffering, so when they pass, you see it from the perspective that their suffering has ended. But someone who knew them when they were healthy will imagine the great life that they once had, but will never have again.

[KelRN215, BSN, RN]

At diagnosis, you can get a small idea of what the patient was like before... before the cancer begins to rob them of their identity. After you've seen this process take hold and when you know that they will never again be the person they once were, the end to their suffering does begin to feel like relief.

I have been working in pediatric oncology for 5 years... first in the hospital and now in home care. My favorite patient ever died in January... when I met her last April, she was a vibrant 9 year old who presented with a few weeks of headaches and ataxia. A few days later, she was hemiplegic, incontinent, scared as heck but still the sweetest little girl you could ever meet. As the cancer progressed, she lost her ability to speak, walk, eat, etc. When she finally passed (after several admissions wherein her parents revoked her DNR and had her intubated or put on BiPAP), it was a relief. And I don't think it was a relief because I didn't know her when she was well... I got a glimpse of who she was when I first met her, it was a relief because of how the cancer had robbed her of who she was when she was well.