November 16, 2012
The first thing I felt was my heart beating rapidly. I had just stepped onto the elevator, and hoped more people would join before I reached the 4th floor. I had no such luck. I was quickly transported to the 4th floor, and made my way down the halls, navigating to the right ward. There's a man in a room who has cancer. I am terrified he won't like me, that he'll tell me go to away, and that I will be a failure. My supervisor assures me that anxiety is normal. I have to do a palliative biopsychosocial assessment, which asks typical questions, such as the state of the client's mood and appearance. I also have to ask more daunting ones, such as the client's spiritual beliefs, if any, and if he has funeral plans. I can't think of a more awkward question. Besides my role in taking assessments, I see myself as an advocate, and a therapist on wheels. I make sure to invest in my clients, to spend time with them in a busy hospital.
My current field placement is at the Veterans Hospital in Manhattan, which is under the VA New York Harbor Healthcare System. I am a social work intern in the Geriatric Clinic, which provides services to elderly patients, and in the Palliative Clinic, which works with people who have chronic or possibly terminal health conditions. Essentially, I have been dealing with the realization that my clients are suffering or will die. I knew this possibility was real when I had applied to the Silver School's Zelda Foster Studies in Palliative and End-of-Life Care Focused Learning Opportunity. I am in the first year of a four-year journey. The first year encompasses a year of field learning during my second year of the MSW program. Years two and three require working in the field where students are paired with a mentor from the field, and year four includes post-master's education opportunities. Students in the cohort meet once a month during the first year to discuss palliative care, and any issues that arise at their field placements.
I am looking forward to the years ahead. Working with people in end-of-life care has already given me a new appreciation for life. I try to make sure I allot time for things I enjoy, such as reading and writing. I call my family frequently, and visit them as much as I can. I don't forget the importance of friendships. These are things that not everyone has the opportunity reexamine, and I feel fortunate that I have already had this opportunity at 23 years old. Who knows what lies ahead?
While uncertainty can be scary, this is the reality my clients are facing. They need someone who cares about them and who can talk about these issues frankly. I think of one moment, when I had to call a client to let him know we processed his hospice referral, which meant he would receive end-of-life services at home. Out of cultural necessity, I asked how he was doing, and he replied, "Not too good." What answer had I expected? But I've learned it's ok for someone to not be ok, and that my role isn't always to make things ok, but to listen. I remember my humanness, and that I can't make cancer go away.
There have been days I feel exhilarated, that I could be a source of support to someone in such a hard time. I love hearing people's life stories. You have to be patient and maintain a calm energy about you. There have been times clients have been irate, moaning in pain and frustration, which is very hard to see a patient go through. If you can "hold on" with them in this hard time, you can see another side of the client. And then there are days, I hurriedly walk down 6th Avenue to 23rd Street, get on the next PATH train, and fly up to my apartment. I sit on the couch and decompress, too exhausted to do process recordings, or even readings for class. I'm fortunate if I can survive 20 minutes in the gym, or make it to the store to pick up dinner, let alone cook it (I won't even go there, I only cook on weekends now.). Despite the balance I am trying to maintain in my own life, the thank yous I receive from clients for merely speaking with them for a few moments is worth the stress and worry I deal with at times. I have realized more worth in my life, and that of others. We can't control time, but we can control how we use it.
By Rachel McCroy, MSW '13