I learned of Andrew George when he contacted Providence Holy Cross Medical Center with an intriguing idea. Andrew wanted to create a series of portraits revealing the resolve and strength of a palliative care patient population. Wanting to know more about Andrew, I checked his website and looked through his previous works, which included still life pictures of sceneries, landscapes and abstract images. I remember thinking this would be interesting! We had expected lovely portraits of our palliative care patients, especially given Andrew’s ability to capture light and color. But, what we received was markedly much more. Revealed in each portrait was the depth to each individual soul; the window to each person’s struggles as well as their aspirations. Each person’s journey unveiled.
It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has. 1
But why choose this subset of patients? What can palliative care patients offer us? And what does palliative care contribute to each of these individuals? These were the questions that burned in our minds as we looked to select each individual presented in this book.
At its onset, palliative care was the root of hospice care: treating those with terminal conditions at the end of life. But, as patients, on average, started to live longer with chronic and serious illness, palliative care was able to break away from the terminality of care and provide ongoing supportive remedies in parallel with treatments such as chemotherapy, aggressive heart disease control, organ transplantation management and other forms of disease-modifying therapies. And, it is because of this approach to whole person care that palliative care is now being accepted so widely throughout the world. Attending to the physical ailments as well as the emotional wellbeing, spiritual health and the social dynamics is how palliative care contributes to the overall comfort of each ailing individual. Getting to the core of the patient as an individual was the key in recognizing how best to formulate a care plan. Seeing beyond the disease to meet the individual where they are at in their journey. When we reflect on our patients, we do not describe them as the patient with the particular disease but rather the person with the unique story. We are inspired by the tenacity these individuals have had in their struggles, overcoming barriers in life, living with regrets but also sharing in their dreams and passions. Each with a story to share and reflecting on their unique lives in ways no one had ever heard. I remember talking with the granddaughter of Donald (a patient you will read about in this book). There were things that Donald had shared with Andrew that no one in Donald’s family had ever heard or experienced. This is what is captured in the coming pages.
Working alongside Andrew has been particularly rewarding for me as well as my team. Watching his ability to capture color in the simplest elements of a hospital room and reflecting light onto the faces of each patient was a delicate process. Finding beauty in the sterility of a hospital environment is not simple. But the challenge of the seeming monotony makes his images so powerful. Having taken the cues from observing Andrew’s work, I too was able to see my work from a different light. In health care, we see many patients with similar conditions, and the treatment often times is algorithmic (as many physicians can attest). This method to care can easily overlook the individual living with the disease. And watching Andrew work with the patients in this book gave me more perspective on my own approach to doctoring. I have found that I no longer treat a disease; I now care for the patient.
I would like to thank Andrew for giving these individuals a platform to share their life experiences. His strength is the ability to see that special quality in the individual and to ask the hard questions about love and regrets, pain and disease. He has presented us with the challenge to examine our own lives and re-evaluate our priorities in hopes of minimizing regrets.
But, this book could not be possible without our patients who were brave enough to answer the questions posed. Thank you for sharing your lives with us and allowing us to learn from your experiences. We cherish your insights and will keep your wisdom close to heart.
Together, we answer the call of every person we serve: Know me, Care for me, Ease my way. 2
Marwa Kilani, M.D.
Medical Director, Palliative Care
Providence Holy Cross Medical Center
Mission Hills, California
1. William Osler, 1849-1919
2. Providence Health & Services vision statement