Dignity and life: UCSC pre-med students paired with patients for course in compassion

November 25, 2016

Dominican Oaks resident Raymond Millard gets regular visits from Hospice volunteer Eric Flores. (Dan Coyro -- Santa Cruz Sentinel)

SANTA CRUZ >> Ray Millard’s room in the retirement home has a great view of the cemetery.

The irony is not lost on the 82-year-old Navy veteran, who was diagnosed three years ago with Parkinson’s disease. In fact, he’s got a pretty good sense of humor about it.

One of Millard’s favorite jokes these days is about a man visiting the doctor’s office. The doctor says he’s stymied by the patient’s symptoms, so he sends him to the hospital. The hospital can’t figure out a treatment plan, so sends the man to a specialist.

“The specialist can’t do anything for you either, so he sends you across the street,” said Millard, pointing to the cemetery. “You’ve heard of one-stop shopping? This is one-stop living.”

Millard, who said he believes one reason he was put on Earth is to make people laugh, is one of about a thousand patients this year receiving care from Hospice of Santa Cruz County, a nonprofit whose vision for the community is for residents to live and die with dignity.

HOSPICE AND UCSC

In October, Hospice of Santa Cruz County was recognized for its Volunteer Visitor Pre-Med program, which recruits hospice volunteers from the Health Sciences internship program at UC Santa Cruz. The students, who now make up 10 percent of Hospice of Santa Cruz County’s volunteer base, provide companionship, run errands and hold bedside vigils for dying patients.

The students are also exposed to the process of dying, a topic rarely discussed in medical school. That’s an experience hospice workers hope will help future doctors consider more end-of-life options for patients, who may prefer to end treatments and die at home rather than a hospital bed.

“In the long run, if we can provide opportunities for future physicians to be at the bedside, conversations with dying patients and hospice referrals will come more naturally to them as physicians,” said Forbes Ellis, director of volunteer services at Hospice of Santa Cruz County.

Millard’s hospice volunteer, UCSC premed student Eric Flores Alvarez, says his studies so far have not included conversations about death, or dying with dignity.

“I guess it’s just too taboo, too sensitive to be talking about, and we don’t pay much attention to it,” said Alvarez ,who plans to study internal medicine and advocate for the uninsured and underinsured. “But hospice is a whole different story. In the training, we’d always talk about death, and how we can normalize the discussion, how we can sit down and engage with it.” 

BEING MORTAL

The program was inspired by the bestselling book “Being Mortal,” written by Dr. Atul Gawande, as well as the documentary by the same name. The works explore how patients and doctors struggle with the topic of death and dying, and advocate for the patient’s quality of life.

Last Thursday, Hospice of Santa Cruz County screened “Being Mortal” for the second time this year at the Del Mar Theater. The first screening, in October, was so well-attended that movie-goers were turned away for lack of seats. The film is also available on YouTube.

Alvarez visits Millard for four hours once a week, in addition to taking 14 units and working nine hours on campus. It’s clear their favorite thing to do together is play bingo for a buck a card with other seniors. 

“I can’t go anywhere without a chauffeur, so he pushes my wheelchair to bingo,” said Millard.

“He introduces me as his personal body guard,” said Alvarez.

Last week Millard won $29 at the bingo table, bringing his total winnings to more than $7,000 in the last four years. Alvarez, not so lucky, is going to keep his day job studying medicine.

Millard, born in Rochester, N.Y., is an upbeat guy, who has “enjoyed every job I ever had,” mostly working in union shops as a member of the United Auto Workers and the International Brotherhood of Electrical Workers. 

He served as an electrician in the Navy on a four-year cruise that began in 1953, keeping equipment running aboard the aircraft carrier USS Bon Homme Richard. He also worked as a lineman’s assistant for the city of Azusa’s power company. Later, he worked at the Chrysler plant in Norwalk, attaching motor numbers to engines and frames as Chryslers rolled by on an assembly line. He was a volunteer firefighter for 23 years in Washington.

One job that didn’t work out so well was at a Huffy bicycle plant, where he tested bicycles for sulfuric acid residue by sucking fumes through a straw, he said. “That’s when I got bounced for trying to get the union in. Only place I worked that wasn’t union,” he said.

GROWING OLD

His good nature aside, Millard said getting old and living with Parkinson’s disease — a degenerative condition that affects nerve cells in the brain — is frustrating. 

“I sit here talking, and my hand can start going like this,” he said, simulating a hand tremor, one of the disease’s signature symptoms. “And when I’m talking to you now, I miss so many words.”

Millard says he doesn’t think about death — “Never.” But then he tells a story about a friend at the retirement home who also had Parkinson’s, who already died at age 75.

“He lives across the street now,” he said, gesturing toward the cemetery.

Millard said when he was young, he never thought much about growing old. And now that he’s old, he is frustrated by basic things, such as not being able to choose where he sits to eat, and not being able to go outside to work crossword puzzles without asking the staff to assist him.

And while he says he doesn’t think about death, he talks about his wife, Joyce, dying in the same facility he’s in now. He keeps pictures of her seven children — his step children — on his refrigerator door. There’s a picture of Joyce there, too.

“She lives across the street now,” he said.

Alvarez says end-of-life processes are difficult for everyone around the patients, even the volunteers. Hospice provides grief support for family members, and is also at the ready to counsel volunteers whose lose a patient.

While in Oaxaca on a medical internship, one of Alvarez’s hospice patients was weighing on his mind, so he emailed Forbes, who advised thinking of the patient while meditating.

Alvarez says it brought him some peace.

Millard seems proud of Alvarez’s choice to pursue medical school.

“I hope he makes it. We need more doctors,” said Millard.

“Thanks, Ray,” Alvarez responded.

“He’s gotta learn to play bingo a little better, though,” Millard joked.

Hospice of Santa Cruz County was awarded the Outstanding Program Achievement Award by the California Hospice and Palliative Care Association in October.

Hospice volunteers commit to four hours a week visiting patients for a minimum of one year. To learn about becoming a volunteer, call 831-430-3045, email fellis@hospicesantacruz.org or visit www.hospicesantacruz.org.

Hospice care

Hospice care is a benefit offered by Medicare, available to patients expected to live six months or fewer. Patients are assigned to a hospice team, including a hospice physician, hospice nurse, hospice aide, social worker, chaplain, grief support and a volunteer, who all work with the patient’s personal physician.

Grief support is provided at no charge to family and friends for a year following a patient’s death.

Hospice also offers pet companions and faith outreach services.

Information: hospicesantacruz.org.

http://www.santacruzsentinel.com/health/20161125/dignity-and-life-ucsc-pre-med-students-paired-with-patients-for-course-in-compassion