Trust Falls

Goss recalls a patient from a palliative care elective during her residency who vividly expressed the joyful moments of her life, a counterbalance that helps her accept her death. Julia begins today's visit by describing her pleasure upon eating a chocolate brownie and then her pain when she swallowed. As a resident, she has spent 2 years running around this hospital, reacting to emergencies, steering conversations, completing tasks. This may be the first clinical encounter in 2 years where her only responsibility is to observe. She drifts from face to face. Julia's is witty, sharp, perceptive; she is interested in them, in language, in stories, even as her body extinguishes her. Today Julia is reflecting on dying. A weekend passes before we see her again. She is tired now, speaking little, long pauses between short phrases.