在宅医として必要なこと
これまでの十数年間、医師として、心臓という臓器を診る、心臓専門医であったわたしが、
在宅訪問診療の現場において、在宅医として末期がんの同世代の男性を診ることになった。
先輩在宅専門医師よりいただいた２つの教えを思い出す。
「在宅医は、臓器ではなく、人を診る」
「人は、楽しい記憶は、奥に眠っている」
症状緩和のひとつとして、楽しかった記憶の回顧、そして少しでも笑顔を出してもらうことに全力を注いだ。
高校時代、学校の屋上から見た花火大会、暑かった体育館でのバスケット部の合宿、はじめての女の子とのデート
大学時代、スポーツカーに乗り、夏はサーフィン、冬はスキー
往診開始から２週間後、家族からはじめて、「息子が先生とまた話したいと言っています」と連絡をもらった。
わたしは、その日の往診患者を終えると、足早に彼の家へ向かった。
彼から、笑い声が出た
そして天井を仰ぎながら一言
「あー、あのときは楽しかったなあー」
そして、翌週、早朝に亡くなった。
研修医のときのように、精一杯、真正面から彼と向きあった日々を思い出した。
そして家族から、「先生と会えて、良かった。。。」
患者の前で泣いたことがないわたしは、目の奥から、熱いものが溢れてくるのがわかった。
心からご冥福をお祈りするとともに、彼そしてご家族に感謝します。
What it takes to be a home doctor
I have been specialized in cardiology treating organ called heart as a doctor inthe past decade. But, as a home visiting physician, I cared a terminal cancer patient whose age was thesame as me. I remembered two lessons my senior home visiting physicians taught me before.
"Home visiting physician treats not the organ, but the people."
"Good memories of a person lay deep inside of him/her."
As apalliative care, I focused on bringing back his good memories from the past to put a smile on his face. Firework show that he saw from the school balcony, practicing his basketball game at training camp and going out with his first girlfriend during his high school years... Driving his car, surfing during the summer and skiing during winter during his college years...
After two weeks since I started visiting him, his family contacted me and told me that "My son wants to talk to you." That day, I went to see him as soon as I finished my schedule for the day. He laughedfor the first time and said "I really had lots of fun as a youngster" looking at a distance.
He passedaway early morning of the following week. I remembered the days in my residency facing every patient with all the knowledge I had and all the effort that I could put into. And, His family told me "We are very fortunate that you were his homedoctor" I felt my emotion being filled to the brim and felt tears filling my eyes.
May his soul rest in peace and I appreciate him and his family.
