Ask Not For Whom The Robot Cometh…

Did you see the story about the robot doctor that was sent to deliver bad news to a terminal patient? His daughter was with him when the telehealth machine rolled up to his bedside. On the flickering screen, a physician informed the patient that he was going to die, very soon – perhaps too soon to go home. Daughter Catherine was appalled at the coldness of what should have been a human interaction. So were a lot of other people; so was I. The story went viral on social media, prompting somewhat clumsy efforts by Kaiser Permanente to tamp down the overwhelmingly negative response. But there no denying the pain this awful misstep had caused:

"My dad's reaction was, well I guess I'm going to go quickly then and put his head down-- that was it," said daughter Catherine Quintana.



A prognosis that would have been difficult to accept under any circumstance, became even more painful for the Quintana family of Fremont when the doctor used a robot to deliver the bad news.”

I’m no Luddite, but count me out for this part of the robot revolution. The last place we need to be overtaken by AI is in hospice. We’re dealing with patients at the end of their lives, and families at the end of their emotional ropes: This is not the place to cut corners or shoot for efficiency over human contact, but I fear it’s the way we’re headed.

When was the last time you were in a hospital? Do you recall how often a nurse touched you in a caring way, held your hand or gave your loved one a tender hug? I have watched nurses and aides do vital signs without touching a patient with anything other than the machine they’re using. No eye to eye contact; just get those meds given or treatment done and go on to the next. Aides might give a bath but the RN’s now are often at arm’s length from the patient. What’s wrong with this picture?

What are we “selling” in hospice? Simply access to pain medication? Saving someone from having to call 911 when a family member dies? In a word, convenience?

Or are we selling compassion, the ability to look someone in the eye with empathy and indeed love and tell them the truth, hold a hand, give a hug, share a tear? Humanity – the very best of humanity - is what we are selling and we cannot forget it. I am all for technology that makes jobs easier for the humans who are doing them. I can’t wait for self-driving cars, so that hospice staff can chart on the way to the next patient’s home, or for gizmos that help families dispense medications on time, for instance.

But when it comes time to tell someone they are dying, that they will not be getting well or going home, and there is nothing more to be done? Please, let’s keep that a human interaction, person to person, heart to heart. It’s too big, too overwhelming, too important to hand off to a machine.

Yes, rural hospitals are closing (see the story below) and technology will likely be used to make up some of the gaps. But no one should have to hear they are dying from a robot. Our healthcare is broken when the bottom line is more important than the health of a community. It is a symptom we have lost our way. And now, some of the not-for-profit hospitals and even hospices are in jeopardy of losing their special tax status because they do not give enough back to the communities they serve.

Why are we in the business of healthcare, when the care has vanished? Does our responsibility stop at caring only for the physical being? We are so much more than that; we are emotional and spiritual beings living in physical bodies. Hospice has always been about caring for all three aspects – the body, the mind, the soul.

Don’t lose that - or if you do, you should consider selling cars.

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Like it or not, telehealth is here to stay. Hospital and hospice closures and a shortage of primary care and other physicians, especially in the rural parts of our country, mean that virtual doctors will become the new normal. Unfortunately, this story could have been written about too many small communities today:

“The hospital has been operated by the city-owned medical center in Cookeville, which decided in late January to cut its losses after trying to find a buyer. Cookeville Regional Medical Center officials declined to be interviewed for this story, but they explained in writing that the facility faced the grim reality for many rural providers.

"Unfortunately, many rural hospitals across the country are having a difficult time and facing the same challenges, like declining reimbursements and lower patient volumes, that Cumberland River Hospital has experienced," CEO Paul Korth says in a statement.

The closest hospital is now 18 miles away, in the town of Livingston. That adds another 30 minutes through mountain roads for those who need an X-ray or blood work. For those in the back of an ambulance, it could make the difference between life or death.”

Here’s a fascinating application for another technological disruptor; a way that the living may see the experience of death (or as much as we can know of it) through the eyes of a dying person, via virtual reality:

“As a journalist, you have a chance to do some interesting things for stories. Over the years, I’ve jumped out of a plane, driven a race car, toured the bowels of a nuclear plant, and kayaked the Kennebec Gorge.

But this week was the first time I’d ever had a brush with death, virtually or otherwise.

I suspect that on a subconscious level, most of us feel a little like the writer William Saroyan, who, days before his own passing, said this: “Everybody has got to die, but I have always believed an exception would be made in my case. Now what?”

Who knows? But for a hint, you can don a video headset with earpieces — and quickly find yourself immersed in a three-dimensional virtual-reality experience. You are Clay Crowder, a 66-year-old veteran in the last stages of a battle with terminal lung cancer….”

CLIENT SUCCESS STORIES:

Hearty congratulations to our friends at Suncoast Hospice, for this dual achievement; 40 years of providing compassionate hospice services to the community, and producing this wonderful book about it:

“Tampa Bay’s Original Hospice Releases Book Detailing Its 40+ Year History:

Suncoast Hospice, a member of Empath Health, announced today the release of the book A Caring Sanctuary, Suncoast Hospice: Forty Years of Caring by Dr. Mary Jean Etten and Betty Oldainie. This intimate history reflects on the origins of hospice in the Tampa Bay area.

In 1976, a group of like-minded people in Pinellas County took on the challenge of changing the way people died in their community. From this group of compassionate people grew Suncoast Hospice, one of the nation’s largest and most highly-respected nonprofit hospices. Over the past 40 years, more than 170,000 people have been served by the love and expertise of its compassionate staff and volunteers, regardless of the ability to pay for services.”

Hospices giving back to the community by supporting other non-profits? It’s a great idea, and part of the mission at Androscoggin Home Healthcare and Hospice:

Androscoggin Home Healthcare and Hospice has selected the Greater Androscoggin Humane Society to be their 2019 Community Partner. Each year, nominations are collected and votes are cast by the staff of Androscoggin to select another local non-profit organization to be the beneficiary of AndroGIVES, Androscoggin’s staff-led fundraising and community support initiative. “As a non-profit organization ourselves, we understand just how vital the support of our donors, sponsors, and community members is to our survival,” said Ken Albert, President and CEO of Androscoggin. “As such, we created AndroGIVES, so that we can in turn show that same level of support to another local non-profit, all to help improve the quality of life for our patients in the communities we serve.”

PAUSE AND BREATHE

Enjoy a sunset from the RiverCove Retreat Center