Going behind the scenes of one of the world’s most admirable professions.
Sometimes we forget that there are so many heroes in our midst—folks quietly going about daily duties that save lives and positively impact our immediate community and the world beyond. These hardworking souls are brave, wise, kind, humble and stronger than often seems humanly possible.
We recently spoke with one such Seattleite—Jodie David, a nurse in the Supportive and Palliative Care service at the Seattle Cancer Care Alliance. We are so grateful for her work and wanted to share her story with you.
Q: How did you get into this line of work, and can you briefly recap the journey that led you to where you are today?
I took a long road to end up where I originally wanted to start. In nursing school in the 1990s, I was interested in end-of-life issues. Palliative care did not exist in a way that it does now, but hospice did. Back then, I think I read every book I could get my hands on about end-of-life issues and coping with life-limiting illnesses: nursing perspectives, spiritual and religious perspectives, artistic perspectives, and point-of-view perspectives, ethical and legal perspectives. I resonated with the idea of wanting to help people live their lives as fully as possible, in whatever way that meant for them, until the end of their life.
I also loved scientific inquiry and biomedical research. By chance or by providence, I landed a job in oncology research after graduation and ended up making a career out of it. As my 40th birthday started looming, I did that cliché re-evaluating my entire life. I loved working in research. I was passionate about the work, but there was a piece missing. I kept returning to those 20-year-old thoughts of wanting to “help people live their lives as fully as possible.” I started working with my mentor to try to figure out what that might look like.
About this same time, one of my colleagues wanted me to meet a friend of his who was a palliative care physician to discuss my interests and gain some guidance about next steps. That meeting crystalized my thinking and provided the catalyst I needed. Within a year, I had decided to go back to school to become a nurse practitioner in palliative care, as there aren’t many positions open in palliative care the RN level. At the exact same time, an opening for a palliative care nurse opened up at the SCCA. The team took a chance on hiring me, and now I’ve been working my dream job for almost three years.
Q: Can you describe a ‘typical’ day in your field?
A typical day in palliative care is as varied as the different settings in which the work is performed. Palliative care is performed in hospitals, clinics, people’s homes. There is even a team in Seattle that provides palliative care to those without homes–living in shelters and the streets. “Meeting people where they are at, no matter where they are at” is such an important concept in palliative care, and it is inspiring to me to see how clinicians find ways to provide care in non-traditional medical settings.
My team works in an outpatient clinic setting at a cancer center. Overall, our job is to help our patients achieve the best quality of life possible. Because we focus on the whole person and their family, this can look very different for each patient and each day. We help patients manage physical symptoms, like pain or fatigue. We provide support to patients and families in coping with the emotional roller coaster that can happen when facing a serious illness. We help patients align their decisions about their medical treatments with their goals and values, as well as completing their advanced directives.
Q: What’s one piece of advice you wish you’d known for your first day on the job?
A piece of advice I wish I understood my first day, and one that I still need to remind myself is: Sometimes a situation is not fixable, no matter how much I wish differently.
The wisdom in realizing that a situation cannot be fixed does not mean that there is nothing to be done! There is plenty to do! Being able to bear witness with someone who is going through something unimaginable, to truly be present with them in those tough, scary, vulnerable moments—that is also a powerful and necessary medicine.
Q: What’s the toughest part of your profession? The most surprising? The most rewarding?
The toughest part for me really is when I am not able to fix things that are not fixable. Despite knowing that—at times—there is no magical answer that is going to fix all the issues and make everything better, I still want to find that solution.
The most surprising part of my profession is seeing how resilient people are in the face of difficulty. Having a cancer diagnosis is hard. Caring for someone you love who has cancer is hard. Yet, my patients and their loved ones continue to find times of celebration and joy, even in the midst of what can be the toughest times in their lives. It is amazing to me. I am in awe of the grace, grit and spirit that they embody and bring out in themselves. I have learned through them that, no matter what, hope always remains.
Q: How do you manage to leave the work you do at the office, or is something you carry with you always?
On one hand, I would love to say that I never bring my work home, but I don’t know anyone who is always successful in doing that. I do try to notice if I am carrying around a big emotion or if I am ruminating about a particular patient or situation. That tends to be a signal to me that I need to stop and do some reflection on exactly what is weighing on me.
On the other hand, I keep and hold people’s stories. People share their laughter, their fears, their wisdom and follies with me. Those stories are gifts that patients shared with me, and every person I work with leaves his or her mark. It’s one of the things I love most about this job—hearing the stories that people share about themselves and their lives. It’s powerful.
Q: Considering a livelihood in which you’re always taking care of others, how do you ensure you’re also taking care of yourself?
Self-care is vital for anyone who spends time caring for others—either professionally or personally. It took me years to embrace the idea of self-care, but a friend gave me a great analogy that changed my mind. She said something to the effect of: If I was a carpenter, I would care for my hammer. If I played in an orchestra, I would take great care of my violin. Since I am a nurse, my tool for my job is myself. Why would caring for my tool be any different than what the musician or carpenter does? It changed my whole mindset.
As a newer palliative care clinician, I am discovering what self-care activities will sustain me in this work. What I need now is very different from what I needed working in research. It became very apparent early on in this career that self-care needs to be a priority that encompasses multiple daily habits. Spending time in my garden, engaging in a spiritual practice, exercising and taking moments of mindfulness throughout the day—even just a deep breath and consciously collecting myself for a moment—are vital to my well-being.
Q: You recently had a very memorable interaction with a patient. Are you able to tell us about that experience?
A gentleman that I cared for unfortunately had to place his daughter in foster care due to some tough life situations, but he remained involved with his daughter and her foster family. The foster family had not only embraced his daughter, but also welcomed him into their family. I remember the way my patient would talk about this family, and it was so apparent the regard that they had for one another. He spoke about them as if he were speaking about his own family.
When I met him, he had been diagnosed with an incurable cancer. He was a very thoughtful gentleman who was focused on making sure his affairs were in order. He used to tell me that he “did not want things left undone” and wanted to make sure that his loved ones “landed safely.”
One of his concerns was that his daughter wouldn’t know or feel connected to her heritage. There was no one else left in his family to teach her either his personal or their cultural history. He and his daughter are African-American, and her foster family is white.
We had long conversations about his values and brainstormed ideas on how he could help his daughter keep a connection to her history. We also talked about “wish lists” or “bucket lists” of things he wanted to do with his daughter. One day he told me that his deepest wish would be to take his daughter and her whole foster family to the Northwest African American Museum and share his cultural history with all of them.
I decided to reach out to the museum to let them know this gentleman’s wish, and they took that wish and created something beyond what I imagined. Not only did the Northwest African American Museum give them a private, guided tour, they also gave everyone a lifetime membership. When he came back, he shared with me every photo they took, the stories shared and told me how the museum staff “treated [them] like royalty.”
I still get emotional when I think about the care and dignity the museum staff gave to him. It was such meaningful support from the community. This was much more than just a day at the museum. They gave this man the peace of knowing that his daughter would always have this place and this community to support her. I am so grateful for the gift they gave to him.
Q: Why did you feel moved to go above and beyond to assist this particular patient?
Palliative Care can help patients find and create meaning in their illness and their lives. One of the ways we assist is by helping people create a legacy, like with this particular gentleman. Because we care for the whole person and seek to understand what is important in our patients’ lives, we see where we can address the needs of our patients outside their physical care.
Q: Why do you continue to do the amazing work you do?
The work itself is amazing. Helping to ease suffering, helping people live fully is the most rewarding work I can imagine. I can’t think of another type of work that would allow me to work on so many different levels with others.
The people on my team are some of the most incredible people I have ever been fortunate enough to meet. Each of them is a wise, wonderful, genuine human being, and I can’t believe my luck in getting to spend my days with them.
Most of all, the patients and the families I work with are truly amazing. Every day people are willing to entrust to me their hopes, worries and dreams. I feel so privileged in being able to join with them and work with them. They inspire me every day.