In Pursuit of Joy: The End

When I started this post a week or so ago I thought it was a simple post about ice skating. It's turned into an absolute flood of complex thoughts and feelings and I hope that it's been interesting for those that have followed it through.

I thought it would be symbolic to finish this series on one of the places where you'd least expect to find joy. That's not only because today is the last day in my current job, the end of an era, but also because joy can be found in all moments of life including at the end of life and that's what I'm in the business of helping with.

For those that don't know I'm a consultant in palliative medicine working in a

hospice. I can pretty much guarantee you that when I tell someone at a party or meeting that this what I do their response will be.

'That must be so sad'

And, of course, it can be. in fact only last Friday I did a 'close friends' insta story about the emotional weight I was feeling after a very heavy day at the hospice. It is however so much more than that.

How can death ever be joyful?

I hear you ask. To that I would tell you you're asking the wrong question. A much better question is.

Can you find hope even in the darkest moments of your life?

I say hope here because over the years I've found that one of the main ingredients for joy is hope. Hope in a better day tomorrow, hope in spending time with your loved ones. Hope that you can make that theatre show you've always wanted to see. It is the fulfilment of that hope that leads to the flourishing of joy in the small things.

That's where we come in. I work as part of a large team of different professionals all with the shared purpose of finding out where someones hope lies and helping to bring it to fruition. We don't often talk about it in those terms, we call it things like 'symptom control' or 'emotional support' or 'spiritual care' or all combined we call it 'holistic care' but really in the end what we're doing is trying to restore hope.

We find out what that hope is and then we try and temper and tailor it to make it realistic. Want to go to New Zealand? Well it might be possible, but it might not be. What is it about New Zealand that attracts you? Would going to the Scottish Highlands instead give you a brief glimpse of what you wanted in New Zealand? It would? Well let's work towards that then.

Want to go to a show in London? Great let's go for it! what do you need? Medication, equipment, nursing support from the team down there? We'll try and make it happen. If for whatever reason you become too unwell to go we'll try and bring you a glimpse of that show to you. A signed programme, a video clip from the cast something that makes you feel joy.

That sounds utterly twee doesn't it. I make it sound as though dying is merely something you need to be distracted from. It is not easy, for anyone involved and we're not successful at finding hope and joy for everyone we look after but we try.

When it does work it's a beautiful thing and I want to give you some insight into what I do and how.

Firstly and most importantly we have to acknowledge that existing and living are not the same thing. Often people are told that they must endure or continue despite their suffering as they need to continue existing. When someone gets into the mental state of endurance then it saps every bit of life or joy from them. They exist rather than live. It can become unbearable and painful to wake up every morning and everything feels pointless. Everyone around them tells them to 'cheer up' or 'keep fighting' when in fact they're just exhausted from always putting on a show for those around them and 'being strong'. When someone is struggling like this, you need to give them permission to feel. They're often containing their emotions just to survive the day when in fact they feel like crap psychologically and physically. Our job is to help them understand that it's actually ok to acknowledge and feel the utter crapness of the situation they're in.

That validation of suffering seems like such a little thing to me but I'm always amazed how many times patients will say 'thank you, no one's ever said that before'. It allows a release to talk about what the difference between existing and living is and in that moment in the release of months of endurance we can talk about what it is that makes life unbearable at the moment, but also what living look life for them. What do they hope for? What do they dream of? What do they miss of the life that was before 'illness'. It's in that moment of being seen as someone more than an illness, more than a standard bearer of suffering, that there's the possibility of the reframing of the road ahead and how they can look again at how they can live now rather than grieve for the future that will never be or long for the past that is gone.

There's so many stories I could tell but they belong to those that lived them. All I did was walk alongside them for a bit and help them navigate a path to hope and joy even though I didn't change where they were heading to.

That is an utter privilege, and I'm lucky to know and care for so many people.

I suppose I want to end this series with a challenge to you all. What's the hope that gets you out of bed? Where can you find it in the little things? Find that meaning of living beyond the daily chore of existence, and I hope you can find joy in your life too.