Palliative Medicine for Serious Illness:
Dr. Ira Mandel MD, MPH, is Medical Director of Pen Bay Healthcare’s Hospice and Palliative Care program
Most people call me a hospice physician. In reality, I am an air traffic controller for souls.
Everywhere in the world, our souls figuratively rise to the sky when they are born and travel the airways of life. Our souls soar as we mature and accomplish great things. As we settle into life, our souls coast along comfortably and easily. In times of trouble, our souls may experience turbulence, dip or dive, pulling up when the crisis has passed.
As an air traffic controller for souls, I am always on the lookout for those who may be coming in for a final landing. From my tower, they are not difficult to find. These souls have lost much altitude or incurred damaged wings. Their engines may be leaking oil, blowing smoke or have nearly empty fuel tanks.
In our human form, it is easy to see souls coming in for their final landing. We see it when humans make repeated trips to the hospital or for their heart disease, lung disease or cancer treatments that don’t work well anymore. We see it when humans become too weak to walk without assistance and need help to dress and to eat.
I try to understand why so many humans and their doctors don’t seem to notice when their souls seem to be coming in for their final landing. Some may have such desperate need and hope for recovery that they are blind to their approaching end of time aloft: “I can’t bear the thought of the end.” Other humans don’t see it because of a fear of not “being there” anymore for their families and friends: “How will they survive without me?” Some humans avoid the inevitable, ignore the flashing Mayday alarms and doom themselves to a crash landing, usually to devastating results for themselves and their unprepared loved ones. In such situations, lingering memories of a terrible crash is often the final outcome.
As an air traffic controller for souls, it is my responsibility to help souls and their human forms know when a landing seems imminent. It is my job to make sure the landings are as safe and comfortable as possible. I check to determine fuel levels, airspeed and altimeter settings. I make sure I can see their contrails from the tower clearly and try to establish radio contact: “How do you hear me? Please report visible damage.” I try to help the soul stay aloft as long as possible to finish the flight as planned: “Go around, circle some more and maintain altitude.” This circling is intended to allow these souls to visit other souls and places to bid farewell, to fulfill dreams before it is too late and to heal damaged relationships while there is time.
When it is time, the landing turns out as planned: dignified, smooth, comfortable, with loved ones around and in the place they want to make their final landing: “Stand by, cleared to land, expedite, make short approach, prepare to dump fuel, make sure landing gear is down and make dead stick landing if needed. Roger? Copy? Acknowledge. Ground control is standing by. Roger Wilco, Godspeed. Over and out.” The soul has made a safe landing, a fitting end to an amazing journey.
I am an air traffic controller for souls. If I establish radio contact with you, do not panic or despair. I will be there to guide you, to help you make the best use of your remaining air time and safely guide you on your journey. All souls will come in for a landing. Please let me help yours be the landing of your hopes and dreams. Roger that? Over and out.
Ira Mandel, M.D., MPH is a Palliative Medicine physician and is medical director of Pen Bay Healthcare’s Hospice and Palliative Care program. He provides compassionate care with a team of health professionals who honor the wishes of patients with serious illnesses. His monthly column seeks to inform the public about choices they may wish to consider. Disclaimer: All people described in this column are not actual patients but are derived from many hundreds of patients Dr. Mandel has treated over many years.