Is it easy to be a palliative care practitioner

In his current book, the palliative medicine specialist Matthias Gockel calls for a new way of dealing with death. Many lived their lives as if it were infinite and then the big break would come. Dealing with it earlier could help.

DOMRADIO.DE: Is dealing with death a social issue?

Matthias Gockel (palliative care specialist and author): Life insurance is taken out in our society. But at the same time the purpose for which it was made is largely hidden. The consequence of this is that you often live your life as if you were going to be something between 150 years old or immortal.

But if you then die at the times that are more likely statistically, then a lot of things have not been done yet. Or, the other way around, assuming that you will be rewarded at some point, you have invested your life in such a way that you cannot enjoy life when you retire. Instead, you get sick. That just creates a lot of despair and anger, which maybe doesn't have to be in every case.

DOMRADIO.DE: You have seen many people die, does death still remain incomprehensible to you?

Rooster: Death itself sure. What I know, what I have seen is dying and ultimately people who have died. But what happens at the moment of death or after it continues to be as a mystery to me as it is to any other person. Because ultimately you will only experience it on your own body or then no longer on your own body.

DOMRADIO.DE: You are in a position where you have to keep telling people that they are going to die. What does that do to you? How is that for you?

Rooster: I think that was one of the hardest parts of the job for a long time. Because many people suppress the option of being able to die, a diagnosis naturally triggers intense feelings. One feeling is: It shouldn't be. That can not be. This is unjust and it must be someone's fault. Then, of course, the person you are talking to is the obvious choice.

That said, I have often encountered anger, anger and reproaches over the years. It was very difficult at the beginning. In the meantime, I acknowledge that this is the way it is for the other without my fault. Suddenly all these feelings are no longer related to me personally. Then I can deal with it completely differently. I can try to help the person in these feelings and despair as much as I can.

DOMRADIO.DE: What is your experience? What does a terminally ill patient need most urgently?

Rooster: What he needs as a unique person at that moment can be very different. I think what everyone needs in such an exceptional situation is the feeling of not being alone. He wants to be seen in his despair and fear and get support. Many just want honest statements. What exactly is the situation? What do I have to prepare for? What time frame are we talking about here? So conversations are important, even if sometimes you may not be able to predict it exactly. I think seeing people as people and being honest are the two most important aspects.

DOMRADIO.DE: How have you experienced that so far? Do people die easier if they believe in the afterlife, if they are believers?

Rooster: I don't think you can answer that across the board. I got to know people who were very calm about their own death. Some of them were actually very firmly anchored in the faith - mostly older people who had an impressive, almost incomprehensible faith. They had a great deal of trust in God.

On the other hand, I have also seen people who saw themselves as very religious and who then suddenly got into trouble with this illness, which was biographically at the worst time.

I don't think you can say that if you want to look into death calmly and relaxed, then become a believer. It probably doesn't work that simple after all.

DOMRADIO.DE: "Why we need a new way of dealing with death "you mentioned in the subtitle of your book" Dying ". What exactly has to be changed?

Rooster: In the meantime I often ask: Has anything changed in your circle of friends since it became known that you had this deadly disease? Almost across the board everyone says: The circle of friends has become smaller. People have withdrawn. However, those who remain support me a lot.

In other words, this taboo subject, the isolation that results from this taboo, urgently needs to be changed. This means that we don't just start talking about death when it cannot be avoided, but ideally see it as a matter of course to talk about it.

DOMRADIO.DE: Palliative medicine is still a very young branch of medicine. But a lot has happened in recent years. Where do we stand today in Germany?

Rooster: You are absolutely right. It is a significant improvement when I look at my first steps into palliative care 20 years ago. At that time, there were only a few palliative wards in the larger cities, perhaps a little more hospices - and there were specific outpatient structures. 20 years later we are now almost - with many restrictions - but formally comprehensive. That means that even in rural areas there is now access to palliative care structures. Nevertheless, there are of course still differences.

What is only just developing now is that palliative medicine is involved much earlier in the case of fatal diseases. This means that the palliative care specialist is already there when the diagnosis is made. Because it is important to help with the fears already at this point in time or simply to have more time to plan your own death and the remaining time of your life.

DOMRADIO.DE: What do you wish for the dying in Germany?

Rooster: Unfortunately, human time does not have the same meaning as, for example, the technical effort. It starts with the payment. You can get chemotherapy for tens of thousands of euros that, statistically speaking, lets you live perhaps two months longer. This is made available by the health system without any problems. For the same money, in principle, you can have a doctor and a nurse sitting by your bed 24/7 just looking after you.

If you look at these differences and then see that in most clinics, simply for reasons of resources, an explanation talk about a fatal illness takes ten minutes, then there is simply an imbalance. That is, I would like to see the dying as just as important as the person to be healed. I don't think that's the case everywhere yet.

The interview was conducted by Hilde Regeniter.