When you tell people you work in hospice and palliative care, common responses are perhaps admiration and condolences. Often people say in their expression if not in their words, “I could never do that!”.

In reading Rebecca Synder’s recent essay This Quiet Lady in JAMA, I was reminded of “painful” lessons we learn.  Dr. Synder recounts her experience of training as a surgical oncologist when her mother is diagnosed with metastatic lung cancer.  This cancer is not amenable to surgery and treatment with both the new and old types of cancer treatments are not helpful but also have disabling side-effects.

In her reflection on her own experience with her mother, she sees that they were more opportunities for presence and meaning-making, for listening rather than telling.  These are all lessons she works to apply in her practice and her own life.  In writing this story, she wants us the reader to learn from this painful experience.

Over 2500 year ago Aeschylus wrote:

“He who learns must suffer. And even in our sleep pain that cannot forget falls drop by drop upon the heart, and in our own despair, against our will, comes wisdom to us by the awful grace of God.”

This observation of the connection of suffering, pain and wisdom is ancient. Learning deep truths about life, death, and meaning requires presence which often requires suffering.

When people say, “I don’t know how you do this kind of work?” I often respond, “I don’t know either.”  Still, I know I have learned so much “drop by drop”; “against my will” by what can be an “awful grace.”


This Quiet Lady: Learning to Be With Patients After a Parent’s Death


This is our 100th post!  Thank you, everyone, who shares this space with us each Tuesday morning.  In honor of this monumental post and your dedicated participation, we are moving to a new site shortly.  Stay with us for a new look and a new decade of Palliative Care perspectives.

Your University of Colorado’s Interprofessional Certificate and Master’s of palliative care team.


Image from David Mark

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