It can be said that a terminal diagnosis is as difficult to give as it is to hear. Physicians often find that, for the most part, patients have a philosophical understanding of where their disease is taking them, but they are fearful of the bumps along the road. That’s the time William Henke, MD suggests taking a step back from the illness and examining what are realistic expectations rather than futile treatments. It means identifying who is involved in the patient’s care and assessing where everyone is relative to future decisions.

When presented with a patient who wants to pursue treatment that he feels will be ineffective, Dr. Henke has the difficult conversation that what they are requesting will not stem the tide of their disease. "Patients then want specifics," he says. "What time do I have left?" "How will I feel down the road?" "What will I no longer be able to do?" That’s where he can offer hope in what is still possible - enjoying a newly planted garden, a grandson’s graduation, a ride in the country or some precious peace and comfort.

Then the next conversation begins. Dr. Henke sees the discussion about hospice care as offering a helping hand to his patients and families. When this offer is framed as an opportunity, it sheds a different light on the situation. "To me, it seems like a tremendous waste of talent and time to simply burn daylight until one dies," he states. Rather than relegating oneself to watching the clock, he encourages his patients to look for the bright spots in each and every day.

You (Hospice) make it much easier for us," he says. "I appreciate it when you set up care conferences with the family members and me. That way, I know I have a specific amount of time to look at the situation with the patient, family and you and determine what their expectations are." From that point, Dr. Henke can frame the conversation around what the patient’s quality of life is now, and what they want it to be for the duration of their illness. He calls it the "ultimate in care coordination."

"Hospice (staff) has the capability of sweeping away fears of pain, abandonment, aloneness - and even any guilt still lingering from the decision to pursue this avenue of care," he says. "I rely on their help to relieve that burden." A patient may even feel defeated, but Dr. Henke is quick to reassure them that they are a real person, not a statistic, and they matter through the end of their life.

And does he ever feel defeated? "Heck yes," he says. "But then I remind myself that I performed a service, supported a family and brought meaning to a very difficult time."

As far as working with the staff at Hospice of the Red River Valley, Dr. Henke says it is a privilege to partner with professional staff who "get it", people who can offer care, comfort and dignity - as well as a strong sense of value in the little things. And if you ask the staff, they will say the feeling is mutual.