The Growing Caregiving Crisis with Jessica Zitter, MD
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You're listening to The Nocturnist Conversations. I'm Emily Silverman. As healthcare workers, we use surgeries and medical treatments to stave off death and disability for as long as possible. But people die, and increasingly, they choose to do so at home. When my guest, Jessica Zitter, embarked on a film about hospice at home with a focus on her dying friend, an unexpected protagonist emerged. The caregiver. A Love Story is the story of a man struggling to care for his dying wife. When 59-year-old Bambi decided to forego further treatment for her cancer and die at home, her husband Rick left his job to become her primary caregiver, a role for which she had no experience and little support. Jessica Zitter is a critical care and palliative care doctor, an author, a filmmaker, and in her words, an accidental activist.
Before our conversation, let's listen to a brief excerpt from her newest film, co-directed with Kevin Gordon, called Caregiver, A Love Story.
I'm not going to say I'm not scared. Who doesn't want to just go to sleep and not wake up, you know? Hopefully it'll just be peaceful and quiet and not cause too much pain to the ones I love. We're just kind of thrust into the role sometimes. And you have to step up. I knew the dancer was starting to take over.
What inspired Dr. Jessica Zitter to create the film *Caregiver: A Love Story*?
We weren't engaged yet. And I told him, this is your get out of jail free card. Next weekend, he came out, pulled out a box. I didn't even open up the box. Just fell into his arms and said yes. It was a pretty big decision because I basically had to leave work. How are you feeling? Are you comfortable? You're not in pain? I'm not trained for this, but this is the best thing for her. How are you? I'm hanging in there. It's a little tough, but I'm doing the best I can.
What I'm hoping they're going to do is raise the methadone dose.
The decline has been more difficult than I expected.
What
happened? And I feel like my health is deteriorating with hers. This is a journey for the end of her life, and I want to give her the best care I can give her. It's all about love.
I am sitting here with the wonderful Dr. Jessica Zitter. Jessica, thank you so much for coming on to The Nocturnist. Ah, so glad to be here with you. So, Jessica, I loved this film, but before we dive in to talk about it, I would love if you could just introduce yourself and talk a little bit about the dual role that you play in both critical care and palliative
care. I came into this world in the early, I guess it was late 90s, and decided that being a doctor meant being sort of a high-tech critical care doctor. And I came in and I pursued this training in critical care, got really good at the ventilators and all the insertions of this and that. I started to realize that there was something missing and, in fact, that I had, in fact, pulled back from my patients and happened to be working in the early 2000s in a hospital that had a very early version palliative care team. They called it the family support team. It was before there was even palliative care, really. And the nurse who ran that team was a strong woman and would really challenge me a lot and wonder why I hadn't told this family that the person was dying when we all knew that this person was dying or hadn't treated this person's pain.
And so I became a convert to palliative care and started to practice both. I've been working at Highland Hospital since then, doing both ICU and palliative care, which gives you a little bit of whiplash. You know, we walk into the ICU, hey, are you here today? Is the ICU attending? Are you the palliative care attending? As if there really would be any difference in what I would do or say about a patient, but that's how we all saw it. It's like these two completely separate subspecialties, but in fact, as I've learned over these past many years of practicing them both, they're really just a blend and should be practiced together all the time.
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