I read a painfully honest account today of implicit bias, something we all have in common as human beings. A doctor shares openly about how she reacts to a family of a patient who is imminently dying, and the disservice she performs secondary to implicit bias. She explains implicit bias as something we do cognitively, on a subconscious level, associating stereotypes and judgments in ways that affect our attitudes and behaviors.

Last week I accompanied another nurse and we sat in the hospital with a 92 year old man who was explaining to us his willingness to go home with hospice, alongside his conveyed goal to live as long as he can and have good days. These two things are not contradictory. Yet the discussion seemed to evolve into a task of signing papers and having his wife make the decisions, after all he was very sick and perhaps he has minimal time left on this earth, so really addressing and understanding his expressed goal of living as long as possible seemed moot. Another lovely elderly man approaching 90 was hospitalized and underwent several procedures prior to going home. I, like others, have this immediate reaction— usually an unexposed opinion about overdoing things when the tired old body is beginning the rapid trajectory towards quitting all together.

I know I am not the only one who considers reaching the age of 90 a very long life; even arriving to one’s eighties as a fait accompli seems momentous. I have this inner dialogue about just accepting the fact that everyone dies, and perhaps an elderly person should reach this point of acquiescing to death without so much fanfare. So, my implicit bias must be recognized, scrutinized, and held in check when I am listening to a person’s life goals. How do they want their days to end, and what do they see in store? I want to be more aware of “my stuff”, simply lay out the options, be honest, and then really listen to how they answer the question. Fact: Life is precious. Fact: We will deal with the end of life in our own way.

Fact: We can’t avoid implicit bias. Our perceptions, our socializations, our expectations of a scenario and the people in it are unique to each of us, developing over our lifetimes, created by the many situations we have encountered. I heard myself say recently, “That’s just the way I am”…and realize what a cop-out that is! Sorry, Amy, no one is compelled to behave a certain way without a choice. Though it is easy to succumb to our preconceived ideas, and “do what we have always done”…we might pause to take some extra moments, listen a little deeper, and be present for those we claim to be providing our time and attention to. We might learn to see and be another way.

The doctor’s story can be read at:
https://palliativeinpractice.org/palliative-pulse/palliative-pulse-june-2017/implicit-bias-and-palliative-care-part-1/?utm_source=Implicit+Bias++-++Friday&utm_campaign=PiP-Implicit+Bias+-+Friday&utm_medium=email