I first met G at bedside handoff when I received report from Polly, RN. Before we entered the room, Polly warned me that G was the sweetest lady and that I would love her- and she was right. 

During Polly’s shift, G had been writing on several pages of blank paper. Polly complimented G’s handwriting, which started the conversation about what she was writing- G had been writing down everything she knew about her cat “Kitters” and the best way to care for her when G was no longer able to. As the conversation grew more glum, G requested Polly check her medical record to see what her cardiologist wrote during her last appointment and read that note to her, so Polly did. The note discloses a poor prognosis due to rapidly progressing heart failure, progressive aortic stenosis, and severe pulmonary hypertension. 

During this encounter with Polly, the patient requested clarification on her new diagnosis and the reason for her hospitalization. This was a heavy explanation as the patient had been diagnosed with a bladder mass, concerned providers of Urothelial Carcinoma, which the mass had almost tripled in size since September. It was noted that because of G’s several comorbidities, her candidacy for surgery, chemotherapy, and radiation was poor, making treatment options limited, so palliative care was consulted to aid with the goals of care planning. 

The day Polly was handing the patient off to me, there were plans for a hospice consult, as G had chosen not to seek treatment but to go home and prioritize comfort and quality of life with her cat Kitters for whatever time remains. I witnessed a special bond between G and Polly during that bedside handoff, giving a heartfelt handshake, both with small tears in their eyes, knowing that what was yet to come for G would be even more difficult. When we left the room, Polly explained that G reminded her so much of her grandmother while she was still fighting those small tears. Hospice came to see G, and the final decision was made that she would go home that day. G wasn’t necessarily excited about what was to come but was eager to get home to Kitters. I had the pleasure of walking G to her parked car on the visitor ramp; as she was about to climb into her car, she said, “Can I have a hug?” and tears flooded our eyes. 

During our hug, she said, “Please make sure to tell Polly how much she touched my heart, and I’m sorry I won’t get to see her tonight; she really meant a lot to me.” It was about 20° the day I walked G out to her car, and she managed to give me the warmest hug on the coldest day despite everything she was going through; I think that’s a true definition of warm-hearted.