We have just finish Family and Community Medicine. What made an impact to me was the last two weeks of it where we had to deal with the terminally ill and the dying. I can say it is really a significant part of the health care yet it is emotionally exhausting. The doctor has to learn the art of bracketing so as not to be involved in the family’s bereavement yet still able to sympathize with them. It is in this rotation that I have appreciated morphine, an opioid acting on the mu-receptors. Morphine is safe as long as the right dosing are followed. It should be given orally as much as possible, but can also be given in the ff order: subcutaneous, rectal/intravenous, and lastly, intramuscular. Three things to ponder when starting this drug are: age (if elderly), kidney function, and liver function.
In Hospice, I have lost some patients also. And sometimes it is really hard when you have had a good rapport with a Bicolano or Bicolana. But then again, death is part of the disease spectrum, or life in general.
I eventually remembered my Lola Maring. If probably I had already rotated in Palliative Medicine and Hospice, I could have done more to help her when she was dying. May she rest in peace.