The Big Guy works in mysterious way sometimes. My TV is rarely turned on but last night I pushed the button and who did I see? Robin Williams performing his portrayal of Patch Adams in the movie by the same name. I've seen this flick a hundred times and I sob every time those kids come out of the shadows with their red noses on. Sick people know who their advocates are.

Belief in this kind of advocacy can only be a gift of mercy for a soft-hearted front line grunt in the healthcare field. My professional training was clinical in nature, but over the years has evolved into a much more touchy feely proposition. Defining and measuring and testing is all well and good, but where is the human aspect of this whole deal? As an old-timer to the biz, I began exploring the possibilities about 5 years ago. Being witness and comfort during the deaths of many patients over my long career has given me a unique perspective on the process. And it IS a process. While sudden tragic death is what captures our attention, chronic disease is slowly taking the lives of the majority. It's a fact....we will all get sick and die. If you don't believe that, you're in denial. If you don't believe you will be asked to minister to someone else who is dying, you're being selfish.

There were several things that changed my perspective on end of life care. One of them was watching a Bill Moyers piece about palliative care that my mom taped for me. I watched it, alone, on a Friday night waiting for time to pick up my then 15 year old daughter. I was a woman on a mission for a couple of years. My favorite Christmas present ever was a copy of Dying Well by Ira Byock. His work brought to fruition the Missoula Demonstration Project in Montana. In a nutshell, that project is about neighbors caring for their own during the last months of life. Byock is a physician who learned through the experience of caring for his terminally ill father that it is a special time of passage for friends and family when things shared = peaceful passage. Honesty, pain relief and community are essential for a "good death", not only for the patient but for the loved ones surrounding him or her.

Doctors, for the most part, don't want to deal with it, especially the old school types who want to be the guy in the white hat. I have jousted at the windmills that are corporate healthcare and I gave it up long ago. Something told me that this was a battle that would be fought one patient and one life at a time in a world where $$$ is the object of the game.

Out there in the big old scary world of death and dying and suffering there are those who give of themselves because they feel called to reach out to another human voluntarily to ease their suffering. Risible Girl is one of those. Go give her a hug and ask her about hospice. She's got stories to tell.