1 00:00:32,479 --> 00:00:35,880 From the very moment of birth, and even before, 2 00:00:36,040 --> 00:00:38,080 we are accompanied. 3 00:00:40,040 --> 00:00:41,400 We are accompanied by our families 4 00:00:42,040 --> 00:00:44,240 and usually by health professionals. 5 00:00:45,480 --> 00:00:48,720 The attachment begins, so necessary to survive; 6 00:00:49,080 --> 00:00:51,800 and so does detachment, giving way to a dance 7 00:00:51,840 --> 00:00:54,480 in which both will be more or less present 8 00:00:54,520 --> 00:00:57,400 throughout our lives. 9 00:00:58,240 --> 00:01:00,040 We are born very vulnerable, 10 00:01:00,520 --> 00:01:02,360 dependent on the surrounding world 11 00:01:02,880 --> 00:01:05,560 and thus our journey begins... 12 00:01:05,680 --> 00:01:08,080 learning with others and from others, 13 00:01:08,520 --> 00:01:12,680 collecting the history and building our own. 14 00:01:13,280 --> 00:01:15,800 The beginning and the end of life 15 00:01:15,960 --> 00:01:18,160 are situations of intense emotions 16 00:01:18,480 --> 00:01:20,680 and of a lot of physical frailty. 17 00:01:21,320 --> 00:01:23,840 Both experiences are of great transcendence 18 00:01:23,960 --> 00:01:26,280 for the people who share them. 19 00:01:32,400 --> 00:01:34,280 Our society has changed, 20 00:01:34,360 --> 00:01:37,360 we live more years and the final period lengthens. 21 00:01:38,200 --> 00:01:40,200 We are in an aged society 22 00:01:40,720 --> 00:01:48,280 and with such guidelines, ways and lifestyles, 23 00:01:48,880 --> 00:01:51,320 that there will increasingly be more people 24 00:01:51,720 --> 00:01:55,200 who are going to find themselves alone at the end of their lives. 25 00:01:55,640 --> 00:01:57,400 Since the middle of last century, 26 00:01:57,760 --> 00:02:00,680 health professionals like Elisabeth Kubler- Ross 27 00:02:01,040 --> 00:02:02,960 and Cicely Saunders, 28 00:02:03,320 --> 00:02:06,120 became aware that at the hospitals, 29 00:02:06,320 --> 00:02:10,400 terminal patients had needs which were not looked after. 30 00:02:11,280 --> 00:02:13,320 The professionals did not take care of them, 31 00:02:13,720 --> 00:02:16,560 considering that they could no longer cure them. 32 00:02:17,720 --> 00:02:19,480 When they became interested in the terminally ill patients, 33 00:02:20,000 --> 00:02:22,960 they found that their situation could be radically improved, 34 00:02:23,360 --> 00:02:25,280 both in the treatment of the pain 35 00:02:25,480 --> 00:02:29,040 as in addressing their emotional and spiritual needs. 36 00:02:30,000 --> 00:02:33,600 Since then, substantial professional knowledge has been accumulated 37 00:02:34,040 --> 00:02:37,400 in the field of palliative cares. 38 00:02:39,560 --> 00:02:43,440 In this documentary, we will try to convey this information 39 00:02:43,960 --> 00:02:48,240 as well as experiences and testimonies of people who have already been through it, 40 00:02:48,720 --> 00:02:52,280 so those experiences may become useful for those who accompany and care. 41 00:02:53,720 --> 00:02:57,280 This documentary is primarily intended to the companion. 42 00:02:58,480 --> 00:03:02,920 When cure turns out to be very unlikely, the priorities change. 43 00:03:03,560 --> 00:03:07,520 Affective and spiritual issues become the most important. 44 00:03:08,240 --> 00:03:10,640 And "even while it is true that the life time is shortened, 45 00:03:11,240 --> 00:03:13,000 it can also be widened". 46 00:03:13,600 --> 00:03:16,200 "You can live a lifetime in a few weeks". 47 00:03:17,280 --> 00:03:22,160 The patients often reappraise what is fundamental to their existence. 48 00:03:23,400 --> 00:03:25,320 They look forward to reconcile and to bid farewell. 49 00:03:26,320 --> 00:03:29,880 They need to settle down what they will be leaving to the others as a legacy 50 00:03:30,520 --> 00:03:33,680 and to consider, in accordance with their own convictions, 51 00:03:34,360 --> 00:03:37,600 the meaning of life and transcendence. 52 00:03:39,880 --> 00:03:41,640 The companions are also facing 53 00:03:41,920 --> 00:03:44,720 the main issues of their own lives 54 00:03:45,280 --> 00:03:48,120 and will have the opportunity to close 55 00:03:48,320 --> 00:03:51,440 in the best possible way their relationship with the patient. 56 00:04:01,600 --> 00:04:03,320 I took my mother down to the emergency ward. 57 00:04:03,640 --> 00:04:09,960 It was November 30th, and I was thinking that she was having a severe infection 58 00:04:10,440 --> 00:04:15,280 and that after stabilizing her, they would send her home to me. 59 00:04:16,000 --> 00:04:18,720 Being told that your mother has cancer is not the worst thing. 60 00:04:19,240 --> 00:04:23,160 For me, the worst was being told that on top of having that cancer, 61 00:04:23,680 --> 00:04:28,320 no one could do anything, anything at all for her. 62 00:04:28,800 --> 00:04:30,400 Nothing but to wait for death to come. 63 00:04:30,680 --> 00:04:33,800 Until they give you the diagnosis 64 00:04:33,800 --> 00:04:36,680 there is a lapse of time, some days of uncertainty, 65 00:04:36,960 --> 00:04:41,560 a time that is really very difficult to bear. 66 00:04:42,160 --> 00:04:47,400 So every day it was like waking up and to start thinking: 67 00:04:47,840 --> 00:04:51,680 Will it be today? Will it be tomorrow? 68 00:04:53,080 --> 00:04:59,720 And this uncertainty, it is as if it were corroding you in the inside. 69 00:05:00,200 --> 00:05:01,040 How can I tell you? 70 00:05:01,240 --> 00:05:03,760 I felt like a shake, a tremor in my whole body, you know what I´m saying? 71 00:05:05,280 --> 00:05:07,880 This is it, already. This is mine. 72 00:05:08,160 --> 00:05:09,920 I have it and this is the end of it. 73 00:05:10,600 --> 00:05:11,880 After the initial disorder, 74 00:05:12,360 --> 00:05:14,960 due to the impact of the news, when overcoming it, 75 00:05:15,640 --> 00:05:19,360 the moment arrives to organise ourselves and to make decisions. 76 00:05:20,320 --> 00:05:23,960 The whole family will be affected because it is necessary to assist the sick person 77 00:05:24,480 --> 00:05:28,280 and to replace them in whichever role they were previously doing. 78 00:05:28,920 --> 00:05:31,640 In the family, if one part moves, 79 00:05:32,080 --> 00:05:35,280 the whole group moves accordingly in order to compensate that. 80 00:05:35,800 --> 00:05:38,120 Where he wanted to be, how he wanted to be... 81 00:05:38,440 --> 00:05:40,800 We would talk with him and with that information, 82 00:05:41,240 --> 00:05:43,320 we would gather, the four siblings, and then we would decide. 83 00:05:44,160 --> 00:05:46,960 Some changes of roles become necessary because of the new situation. 84 00:05:47,520 --> 00:05:51,640 For example, someone who was not in charge of the house issues, 85 00:05:51,960 --> 00:05:55,080 has to start taking them in charge; if there are children, 86 00:05:55,600 --> 00:05:59,400 the children will also have to restructure their life a little bit. 87 00:06:00,040 --> 00:06:03,160 It is important that the patient shares all the information 88 00:06:03,480 --> 00:06:05,520 and that they can make their own decisions. 89 00:06:07,480 --> 00:06:09,400 Then indeed I knew it was going to be a hard impact to say: 90 00:06:09,680 --> 00:06:12,240 "You have cancer". 91 00:06:12,720 --> 00:06:15,240 My concerns were... Who is going to tell him? How do we tell him? 92 00:06:15,800 --> 00:06:17,920 Do we tell him the truth, or we rather don't? 93 00:06:18,280 --> 00:06:20,440 Eventually we agreed a bit grudgingly to do that, 94 00:06:20,800 --> 00:06:23,200 but afterwards we saw that it had been the best thing to do. 95 00:06:24,800 --> 00:06:27,640 It was also what he wanted, and so it was done. 96 00:06:28,160 --> 00:06:29,920 He wanted at all times to know the truth. 97 00:06:30,000 --> 00:06:35,520 The decisions we made, I dare to say 98 00:06:36,160 --> 00:06:38,720 that if not a hundred percent, 99 00:06:38,920 --> 00:06:40,560 at least ninety eight percent were made by my father. 100 00:06:41,160 --> 00:06:43,400 And I think that more and more, every day both patients and caregivers 101 00:06:44,080 --> 00:06:45,520 are being included 102 00:06:45,880 --> 00:06:49,760 to be able to participate in these decisions of rejecting treatment 103 00:06:50,080 --> 00:06:54,040 and preferring palliative approaches from other stages of the illness. 104 00:06:54,560 --> 00:06:58,080 It was at that moment when he said: "Look, I do not want any more chemo; 105 00:06:58,360 --> 00:07:00,080 if I can have radiotherapy, it´s ok. 106 00:07:00,080 --> 00:07:02,480 But not a second time. 107 00:07:02,720 --> 00:07:04,920 I can see by myself that chemo is not working for me. 108 00:07:04,920 --> 00:07:06,680 I don´t want to hear about chemo any more". 109 00:07:07,120 --> 00:07:08,800 So it was then when the oncologist said: 110 00:07:08,800 --> 00:07:10,120 "From here, I leave him in your hands". 111 00:07:10,520 --> 00:07:14,600 Through the Living Will they can record their decisions 112 00:07:14,880 --> 00:07:19,960 for a future moment in which they will not be able to express their preferences. 113 00:07:20,560 --> 00:07:24,760 The Advance Directives are what the patients want to be done 114 00:07:25,120 --> 00:07:27,720 when they cannot decide for themselves anymore. 115 00:07:28,520 --> 00:07:30,280 I would define the Living Will in a simple way 116 00:07:30,640 --> 00:07:33,880 as just a way to extend the autonomy 117 00:07:34,160 --> 00:07:36,480 and the capacity to decide of the sick person, 118 00:07:36,720 --> 00:07:39,640 for when they reach a moment in which they will no longer be able to decide. 119 00:07:40,000 --> 00:07:43,280 The Living Will is not meant for when one can express things. 120 00:07:43,280 --> 00:07:45,960 Although a person has made a Living Will 121 00:07:46,280 --> 00:07:49,360 it will always prevail what they are saying at the time. 122 00:07:49,680 --> 00:07:52,040 One of the decisions to be taken is 123 00:07:52,040 --> 00:07:55,840 whether at the last stage the patient will live in the hospital or at home. 124 00:07:56,520 --> 00:08:00,640 And of course one thing that gratified us, 125 00:08:01,040 --> 00:08:03,920 the nearest family, 126 00:08:04,400 --> 00:08:08,360 very much was to respect at all times what he told us he wanted. 127 00:08:08,720 --> 00:08:10,240 He wanted to die at home. 128 00:08:10,800 --> 00:08:12,400 And his wish was fulfilled. 129 00:08:12,880 --> 00:08:17,720 One can also think: "But that's not so easy... 130 00:08:17,720 --> 00:08:23,040 What if you can not control the illness and you have to hospitalise him?" 131 00:08:23,600 --> 00:08:27,600 But then a moment arrives in which we can not do anything. 132 00:08:27,640 --> 00:08:29,240 Why should he die in a hospital? 133 00:08:31,280 --> 00:08:33,200 And then another phase began in the summer, 134 00:08:33,200 --> 00:08:37,280 when the oncologist said that nothing else could be done. 135 00:08:37,520 --> 00:08:39,280 She told him she could no longer give him any more medication, 136 00:08:39,640 --> 00:08:41,200 because the illness was already advancing 137 00:08:41,520 --> 00:08:45,040 and he had to go with other palliatives practitioners, 138 00:08:45,040 --> 00:08:48,200 who would accompany him in the following process. 139 00:08:48,960 --> 00:08:54,120 And that's when the doctor decided 140 00:08:54,320 --> 00:08:58,280 that the best thing to do, because he will no longer have treatment, 141 00:08:58,520 --> 00:09:00,800 was to refer him to palliative care. 142 00:09:01,560 --> 00:09:07,480 Palliative care is care designed specifically 143 00:09:07,880 --> 00:09:14,800 to alleviate suffering, to improve quality of life, to give comfort 144 00:09:15,680 --> 00:09:21,200 to patients with very advanced chronic diseases, 145 00:09:21,520 --> 00:09:25,600 or in terminal phase, 146 00:09:25,800 --> 00:09:29,640 and to their families, friends and surrounding caregivers. 147 00:09:29,840 --> 00:09:31,640 There is not a precise moment. 148 00:09:31,920 --> 00:09:37,400 But the time arrives in which the possibilities of healing treatment 149 00:09:37,680 --> 00:09:39,720 disappear. 150 00:09:40,000 --> 00:09:41,000 In principle, it will be the medical staff 151 00:09:41,320 --> 00:09:42,600 who will request the intervention 152 00:09:42,960 --> 00:09:44,360 of a palliative care team. 153 00:09:44,760 --> 00:09:46,240 But this does not mean, that sometimes, 154 00:09:46,240 --> 00:09:48,760 even though the professional h as not demanded such services, 155 00:09:48,760 --> 00:09:50,520 if the family knows about it, 156 00:09:50,760 --> 00:09:52,720 they can contact us. 157 00:09:53,320 --> 00:09:55,600 In our case, we are a home care team. 158 00:09:55,880 --> 00:09:59,360 We work seeing the patients, assisting the patients 159 00:09:59,360 --> 00:10:01,040 primarily in their homes. 160 00:10:01,760 --> 00:10:04,320 The first necessity the family has about cares 161 00:10:04,440 --> 00:10:06,640 cares is to know that they can do it. 162 00:10:06,760 --> 00:10:08,120 Many things can be done 163 00:10:08,240 --> 00:10:10,520 and care is what would include all that what´s done; 164 00:10:10,880 --> 00:10:13,800 that is, giving tools to the family, 165 00:10:14,040 --> 00:10:16,840 giving tools to the patient so that they feel 166 00:10:16,920 --> 00:10:19,240 that there is a purpose in being there as they are. 167 00:10:19,560 --> 00:10:23,520 And that the most basic things, as it could be to heat the soup in the microwave 168 00:10:24,120 --> 00:10:26,320 in a cup so that he doesn´t feel it cold when you give it to him; 169 00:10:26,640 --> 00:10:27,720 that is caring. 170 00:10:28,120 --> 00:10:30,840 Teaching the family to prepare certain meals, 171 00:10:30,840 --> 00:10:32,480 not forcing the patient to eat; 172 00:10:32,520 --> 00:10:33,480 that is caring. 173 00:10:33,880 --> 00:10:35,960 Telling him: "You are doing it very well"; 174 00:10:36,240 --> 00:10:36,960 that is caring. 175 00:10:37,480 --> 00:10:39,960 The sanitary education in the most basic things, 176 00:10:40,280 --> 00:10:47,040 as it is the hygiene, the nursing, to learn how to move them in the bed. 177 00:10:47,280 --> 00:10:50,280 We teach them a very basic part 178 00:10:50,680 --> 00:10:53,800 and they usually teach us many more things, 179 00:10:54,080 --> 00:10:57,680 because who really knows the patient is the family. 180 00:10:58,080 --> 00:11:01,600 And it happens that they have invented some ingenious way to turn him around in the bed 181 00:11:01,600 --> 00:11:03,240 that makes you say: "God! We should apply for a patent for this!" 182 00:11:03,440 --> 00:11:07,600 What I´m saying is that I believe that what they need is the confidence in the fact that they can do it. 183 00:11:08,440 --> 00:11:12,680 ...to know that if he has a fever raise, what should I do? 184 00:11:13,120 --> 00:11:18,280 If he has to be transported somewhere, who should I call? 185 00:11:18,680 --> 00:11:23,840 All that information they gave me, re-assured me a lot 186 00:11:23,960 --> 00:11:27,040 In helping to control the pain, 187 00:11:27,280 --> 00:11:29,400 their relatives have a dual role. 188 00:11:29,400 --> 00:11:33,360 There is the merely technical one of administering the medication, 189 00:11:33,600 --> 00:11:35,920 with the doses and guidelines 190 00:11:35,920 --> 00:11:38,280 given by the professionals in charge, 191 00:11:38,600 --> 00:11:40,920 and that usually people do quite well. 192 00:11:41,280 --> 00:11:45,200 But there are other non-pharmacological measures to be taken 193 00:11:45,520 --> 00:11:49,960 which help the patients to have good control of the pain. 194 00:11:50,240 --> 00:11:53,400 For example, to care that the patient is well rested, that they feel accompanied, 195 00:11:53,640 --> 00:11:56,360 that they can communicate with their relatives... 196 00:11:56,840 --> 00:12:00,480 The practice of palliative cares has advanced a lot 197 00:12:01,040 --> 00:12:04,440 and it helps the patients to live their final stage without pain 198 00:12:05,160 --> 00:12:06,920 and at the same time in a lucid state of mind. 199 00:12:07,960 --> 00:12:11,000 Even when there is already a cancer, a terminal illness, anyone, 200 00:12:12,000 --> 00:12:15,000 that doesn't mean the patient has to suffer pain; 201 00:12:15,480 --> 00:12:18,280 there are enough resources for the patient not to suffer. 202 00:12:19,480 --> 00:12:23,560 The truth is that the contribution of the topic of palliatives appeared to us as fundamental, 203 00:12:23,640 --> 00:12:25,960 the contribution in that moment, in how he was. 204 00:12:25,960 --> 00:12:29,200 Because he began to deal there with the whole issue of dying suffocated. 205 00:12:30,080 --> 00:12:35,960 The standard analgesic for patients at the end of the life is morphine. 206 00:12:36,400 --> 00:12:39,120 And with morphine, there is a whole black legend. 207 00:12:39,400 --> 00:12:45,880 Morphine leaves you drowsy, morphine takes lucidity away, 208 00:12:46,000 --> 00:12:49,560 morphine turns you into an addict... 209 00:12:49,760 --> 00:12:53,760 Well, I think all these things have to be banished. 210 00:12:54,640 --> 00:12:56,280 Because now we all know t 211 00:12:56,560 --> 00:13:00,960 that morphine used in patients with severe and intense pain 212 00:13:01,200 --> 00:13:02,600 does not take lucidity away. 213 00:13:03,400 --> 00:13:05,800 Palliative sedation is only applied 214 00:13:05,920 --> 00:13:09,280 as a last resource when pain is already un-treatable. 215 00:13:10,760 --> 00:13:19,160 Palliative sedation consists in administering enough sedative drugs 216 00:13:20,000 --> 00:13:24,400 with the intent to reduce the patient´s level of consciousness, 217 00:13:24,920 --> 00:13:30,200 enough to ensure comfort 218 00:13:30,600 --> 00:13:35,440 and control of the suffering, of pain, of breathlessness, of agitation. 219 00:13:35,640 --> 00:13:40,560 ...to treat symptoms that we can not control in another way, 220 00:13:40,640 --> 00:13:42,960 which we call refractory symptoms. 221 00:13:43,520 --> 00:13:47,520 And to be able to guarantee that people can die without pain, 222 00:13:47,720 --> 00:13:52,520 that they can die without agitation, that they can die without breathing difficulties. 223 00:13:52,600 --> 00:13:55,280 It's something that terrifies people, right? 224 00:13:56,240 --> 00:13:57,680 It is also very important 225 00:13:58,000 --> 00:14:00,760 to know that terminal sedation is not euthanasia, 226 00:14:01,000 --> 00:14:05,160 that terminal sedation is not to collaborate in assisted suicide. 227 00:14:05,440 --> 00:14:09,320 Terminal sedation is, as we are saying, a therapeutic tool. 228 00:14:09,880 --> 00:14:15,560 It is a process absolutely legal. 229 00:14:16,040 --> 00:14:17,480 These two circumstances 230 00:14:17,520 --> 00:14:21,560 are the most frequent to indicate (the need of) palliative sedation. 231 00:14:21,800 --> 00:14:24,720 We are usually at this point near the end of life 232 00:14:25,640 --> 00:14:31,560 life and we have exhausted as well other ways 233 00:14:31,760 --> 00:14:37,200 which don't imply a reduction of the patient's level of consciousness. 234 00:14:37,720 --> 00:14:41,440 Aside from the physical pain, they may suffer for different reasons, 235 00:14:41,560 --> 00:14:43,920 emotional ones, or of social origin... 236 00:14:44,200 --> 00:14:47,720 Therefore, care is not confined to alleviate physical pain; 237 00:14:48,000 --> 00:14:51,760 total pain corresponds with a "total medicine" 238 00:14:51,880 --> 00:14:54,360 which covers all needs. 239 00:14:54,640 --> 00:14:56,720 I understand palliative care 240 00:14:57,000 --> 00:14:59,880 as a person's fundamental right. 241 00:15:00,440 --> 00:15:05,080 Probably if we revise the Universal Declaration of Human Rights, 242 00:15:06,240 --> 00:15:11,520 they are all there, all these care needs in the end of life, 243 00:15:11,600 --> 00:15:14,760 in order to preserve the dignity and the meaning of life. 244 00:15:17,080 --> 00:15:19,480 The patients and their families go aboard 245 00:15:19,560 --> 00:15:22,880 in a process of great instability and emotional intensity. 246 00:15:24,240 --> 00:15:28,440 Well, sometimes it´s like a roller coaster all that, 247 00:15:29,160 --> 00:15:34,400 because those are very important as well as difficult moments. 248 00:15:34,960 --> 00:15:41,240 You feel rage, you feel guilt, then you think; "It´s no big deal, 249 00:15:41,440 --> 00:15:44,600 he´ll recover", you keep hope, 250 00:15:44,720 --> 00:15:48,600 and then perhaps ten minutes later the hope shatters 251 00:15:48,960 --> 00:15:51,880 and we are angry again. 252 00:15:52,600 --> 00:15:56,280 Some stages or steps that can be distinguished are fairly common, 253 00:15:56,880 --> 00:16:00,520 although each one lives them in their own way; variations can appear 254 00:16:00,800 --> 00:16:04,040 in the order, the duration or even the existence of some steps. 255 00:16:05,400 --> 00:16:10,520 The situation of caring for a patient with advanced disease 256 00:16:10,840 --> 00:16:12,960 is, for the family, for the caregiver, 257 00:16:12,960 --> 00:16:16,120 a situation of physical and emotional stress. 258 00:16:16,960 --> 00:16:20,200 Upon receiving the news, it is usual to begin by denying it, 259 00:16:20,680 --> 00:16:24,320 saying for instance: "There must be some mistake". 260 00:16:25,360 --> 00:16:27,160 It is important to find a way 261 00:16:27,160 --> 00:16:31,080 to communicate it to the patient with frankness, but tactfully. 262 00:16:31,720 --> 00:16:33,400 Since the beginning of the summer, 263 00:16:33,680 --> 00:16:37,800 the whole process lasted two months. At first he would not accept the situation. 264 00:16:38,920 --> 00:16:43,520 It was like the doctor was saying: "This is it"... and he: "No". 265 00:16:44,200 --> 00:16:47,800 We can understand this is a notice which is difficult to assume 266 00:16:48,360 --> 00:16:51,120 and denial does the function of a shock absorber, 267 00:16:51,440 --> 00:16:54,920 allowing distance until the patient 268 00:16:55,240 --> 00:16:58,840 is psychologically prepared to accept the new situation. 269 00:16:59,720 --> 00:17:02,000 The patient is entitled to the information, 270 00:17:02,600 --> 00:17:05,520 but is also entitled to not knowing, 271 00:17:05,800 --> 00:17:08,839 or to acknowledge according to a rhythm that is personal. 272 00:17:09,520 --> 00:17:13,000 The right to know does not entail an obligation to know. 273 00:17:13,000 --> 00:17:17,920 Another type of denial is one which occurs in the patient's environment 274 00:17:18,079 --> 00:17:20,920 to simulate that death will not happen. 275 00:17:21,599 --> 00:17:26,240 This is called "the conspiracy of silence". 276 00:17:28,680 --> 00:17:31,880 Many times, the family members, in an effort to protect, 277 00:17:32,240 --> 00:17:35,160 don't want to talk to the patient about the bad prognosis 278 00:17:35,440 --> 00:17:38,200 or the situation of the end of life. 279 00:17:38,480 --> 00:17:46,000 And this puts the patient into an isolation cage, 280 00:17:46,400 --> 00:17:50,400 which often conditions a worse symptomatic control. 281 00:17:50,800 --> 00:17:53,160 The fact that the patient can speak openly about things, 282 00:17:53,400 --> 00:17:56,720 facilitates a lot the control of symptoms in general 283 00:17:56,720 --> 00:17:58,480 and, in particular, the control of pain. 284 00:17:59,680 --> 00:18:01,120 I know that in many occasions, 285 00:18:01,400 --> 00:18:04,200 when there are serious health problems or at the end of life, 286 00:18:04,560 --> 00:18:06,000 you the caregivers try to be so careful 287 00:18:06,240 --> 00:18:09,680 with the sick persons, with the patients, 288 00:18:09,920 --> 00:18:11,600 that at the end you say: "We better don't tell them this 289 00:18:11,880 --> 00:18:13,080 so they are not going to be unsettled". 290 00:18:13,360 --> 00:18:15,560 What I would advise to you, is that with all freedom, 291 00:18:15,800 --> 00:18:19,160 you should be particularly attentive to their gestures, to the signs they send 292 00:18:19,440 --> 00:18:23,160 and from there, it would be about giving back in the form of questions, 293 00:18:23,440 --> 00:18:24,880 so they can feel that are being heard, 294 00:18:25,120 --> 00:18:27,880 the relevance, the centrality that all that has. 295 00:18:28,160 --> 00:18:32,400 To accept illness and death is not the same as resignation. 296 00:18:33,480 --> 00:18:37,280 Resignation is passive and paralyses in front of the suffering. 297 00:18:37,920 --> 00:18:42,080 But the acceptance of the fact that death is unavoidable 298 00:18:42,560 --> 00:18:44,600 opens the way to change things. 299 00:18:45,400 --> 00:18:48,160 And also, I tell to all those who are in such case, in my circumstances, 300 00:18:50,280 --> 00:18:51,920 That there´s nothing to worry about. 301 00:18:51,920 --> 00:18:55,800 And even if one wants to think otherwise, 302 00:18:56,080 --> 00:18:59,760 you will not have anything else, that´s the way things are. 303 00:19:00,600 --> 00:19:07,160 So, there´s no use in going over it again and again. 304 00:19:08,080 --> 00:19:11,720 Initially, the patient may react with anger. 305 00:19:12,400 --> 00:19:15,760 Frequently the question arises: "Why me?" 306 00:19:16,360 --> 00:19:18,800 Then, in that first moment, he didn't accept it. 307 00:19:19,200 --> 00:19:23,400 And some days of non acceptance came by, and anger, later. 308 00:19:23,960 --> 00:19:25,720 He started to get very angry. 309 00:19:25,880 --> 00:19:29,960 Anger can go against oneself, against medical personnel, 310 00:19:30,200 --> 00:19:33,560 against friends or companions, against God... 311 00:19:34,280 --> 00:19:36,560 The most normal thing is that they project the rage 312 00:19:36,560 --> 00:19:40,680 against the people who love them most and who more care of them. 313 00:19:41,600 --> 00:19:44,840 Impatience, frustration, irritability; 314 00:19:45,560 --> 00:19:49,200 this is what the relative is putting on with day by day. 315 00:19:49,880 --> 00:19:53,880 So it may be that the family becomes angry with the patient 316 00:19:54,800 --> 00:20:00,640 and this also creates an ambivalence that is a bit difficult. 317 00:20:00,800 --> 00:20:04,360 How will I possibly be angry with someone who is going to die? 318 00:20:04,600 --> 00:20:09,720 But of course, the person is irritated 319 00:20:09,800 --> 00:20:15,520 and it is difficult to be able to separate that this person who speaks, 320 00:20:16,160 --> 00:20:19,360 this is not him who´s speaking, but rather the illness. 321 00:20:20,320 --> 00:20:22,760 Setting aside some moments, because there were also some of those, of bad temper, 322 00:20:22,840 --> 00:20:25,320 in which he would answer me back in a bad way and such. 323 00:20:26,400 --> 00:20:29,640 But I did understand him, he was having enough; 324 00:20:29,680 --> 00:20:32,360 it was a fight against that which he had. 325 00:20:32,360 --> 00:20:37,200 So I did not feel that he was coming against me, not at any moment. 326 00:20:37,400 --> 00:20:41,120 It was a way to blow off steam, to vent. 327 00:20:41,640 --> 00:20:44,040 A way of saying: "But why has this happened to me? 328 00:20:44,040 --> 00:20:45,640 Why am I locked up here? Why am I suffering this?" 329 00:20:45,760 --> 00:20:48,320 It is just that, they are blowing off steam; 330 00:20:48,640 --> 00:20:53,640 it´s a way to release, a way to release all the anguish that the patient is carrying. 331 00:20:54,480 --> 00:20:56,200 There´s no need to revise the cares, 332 00:20:56,240 --> 00:21:01,600 there´s no need to feel bad or to think that one is not doing it well. 333 00:21:01,840 --> 00:21:04,760 But he was aware so he would back down 334 00:21:05,280 --> 00:21:07,120 and apologise constantly. 335 00:21:07,120 --> 00:21:10,320 "I did not want (to say that), but it´s that I'm nervous sometimes, 336 00:21:10,320 --> 00:21:17,360 is that I can´t accept it, is that I´m going to die and I don´t want to" he would say. 337 00:21:17,720 --> 00:21:22,400 Then, that´s what I would have wanted for me 338 00:21:23,200 --> 00:21:27,400 and what I wanted for me is what I tried to give him. 339 00:21:29,320 --> 00:21:33,520 And there can also come out emotions or feelings, 340 00:21:33,920 --> 00:21:36,000 which sometimes make you feel guilty, you see? 341 00:21:36,000 --> 00:21:38,440 When you see the person who is suffering a lot, 342 00:21:38,680 --> 00:21:42,240 you may want him to die so he will not suffer anymore. 343 00:21:42,240 --> 00:21:44,320 And then later you can feel bad about that. 344 00:21:45,040 --> 00:21:50,760 It is actually quite fair to wish for that person not to suffer, 345 00:21:51,760 --> 00:21:54,080 but this kind of feelings 346 00:21:54,160 --> 00:21:56,840 maybe are not quite socially accepted 347 00:21:59,240 --> 00:22:02,920 and therefore they will generate some guilt. 348 00:22:03,440 --> 00:22:07,760 One of the most inappropriate or less practical feelings, 349 00:22:08,120 --> 00:22:09,520 to say it somehow, 350 00:22:09,600 --> 00:22:11,800 is the feeling of guilt. 351 00:22:12,000 --> 00:22:15,680 And we will only be able to give quality cares 352 00:22:15,680 --> 00:22:18,880 if we are well ourselves. 353 00:22:20,160 --> 00:22:21,240 Negotiation: 354 00:22:22,480 --> 00:22:24,200 an internal dialogue takes place, 355 00:22:24,800 --> 00:22:27,160 as trying to negotiate their situation. 356 00:22:27,880 --> 00:22:32,400 This is usually related with pending matters and farewells. 357 00:22:32,760 --> 00:22:36,840 But once the wedding was over he said: 358 00:22:36,920 --> 00:22:39,680 "I have already kept up, so from now on, whatever comes to me..." 359 00:22:40,160 --> 00:22:42,480 He even told me that: "Whatever comes to me, 360 00:22:43,160 --> 00:22:45,760 I don´t care any more. I don't already care, if I have to die I will die, 361 00:22:46,440 --> 00:22:49,560 if this it is my end I no longer care about it. 362 00:22:50,040 --> 00:22:53,920 I have already kept up with my daughter, with all of you, 363 00:22:54,880 --> 00:22:57,440 I did not want to spoil this beautiful day for my daughter." 364 00:23:00,760 --> 00:23:02,920 When accepting that the situation is unavoidable, 365 00:23:03,000 --> 00:23:05,440 a state of sort of depression comes up 366 00:23:05,880 --> 00:23:08,440 which often can not be avoided. 367 00:23:09,920 --> 00:23:14,360 If the pain is allowed to be expressed, that helps for the final acceptance. 368 00:23:15,680 --> 00:23:18,440 In this sense, there are not useful at all 369 00:23:18,800 --> 00:23:20,960 any forced positive attitudes 370 00:23:21,480 --> 00:23:23,200 or pretending with the intention to cheer up. 371 00:23:23,920 --> 00:23:26,400 Many times few words are needed, 372 00:23:27,000 --> 00:23:32,480 but what can always help is to be there, available. 373 00:23:33,520 --> 00:23:35,320 We have spoken all these things. 374 00:23:35,640 --> 00:23:37,840 We talked about our fears, 375 00:23:38,280 --> 00:23:39,720 about all our concerns. 376 00:23:40,600 --> 00:23:43,080 We have all opened our hearts... 377 00:23:44,480 --> 00:23:46,880 It is truly important to open the hearts... 378 00:23:46,960 --> 00:23:49,840 What I mean is, there are issues that sometimes overwhelm us, 379 00:23:50,360 --> 00:23:53,600 that seem so important, and at the end are not important at all. 380 00:23:53,880 --> 00:23:56,640 ...this need to talk, to be heard without judgment 381 00:23:56,640 --> 00:23:58,680 what he was saying. 382 00:23:59,000 --> 00:24:06,360 That was also a very strong need I saw in him. 383 00:24:06,840 --> 00:24:11,120 The detachment is the rest at the end of the journey. 384 00:24:11,200 --> 00:24:14,520 Moreover, when the time will arrive... 385 00:24:15,320 --> 00:24:17,960 I think I'll even be happy 386 00:24:19,200 --> 00:24:21,160 when the time comes. 387 00:24:22,080 --> 00:24:26,000 Because I know that I will rest as well. 388 00:24:26,900 --> 00:24:29,360 The patient reduces his activity to the minimum, 389 00:24:29,480 --> 00:24:33,680 hardly speaks and loses interest for what surrounds him 390 00:24:33,840 --> 00:24:37,280 He wants to be alone or with much reduced company. 391 00:24:37,920 --> 00:24:41,160 This happens because he is preparing to leave; 392 00:24:41,880 --> 00:24:45,080 and the companions may suffer when feeling ignored 393 00:24:45,560 --> 00:24:48,440 if they don´t understand this stage of detachment. 394 00:24:48,440 --> 00:24:50,480 He needs to go into himself 395 00:24:51,000 --> 00:24:55,640 and he needs to start caring less for those he has around. 396 00:24:55,800 --> 00:24:58,880 That sometimes makes the caregivers feel bad. 397 00:24:59,280 --> 00:25:01,920 Makes them feel that they are not as useful, 398 00:25:01,920 --> 00:25:05,440 or makes them feel that the person they love so much 399 00:25:05,680 --> 00:25:08,280 no longer needs them as much. 400 00:25:10,240 --> 00:25:11,560 It is necessary to let them go. 401 00:25:12,040 --> 00:25:13,720 And for letting them go it is also necessary 402 00:25:13,720 --> 00:25:16,560 to allow them this detachment 403 00:25:17,760 --> 00:25:19,640 To experience that their loved ones 404 00:25:19,840 --> 00:25:21,320 don't accept their death, 405 00:25:21,680 --> 00:25:23,800 can be for the patients a cause for distress. 406 00:25:24,560 --> 00:25:27,000 It is important to "give them permission" to leave. 407 00:25:27,880 --> 00:25:31,760 What it is necessary to do is to let go of the other person. 408 00:25:32,880 --> 00:25:37,160 And then, to let go calmly as well, is important for those who remain. 409 00:25:39,800 --> 00:25:43,080 And he told us many times: "I don't want you to cry for me, 410 00:25:43,120 --> 00:25:46,440 because you will make me suffer a lot, when I am up there, if you cry for me. 411 00:25:47,120 --> 00:25:49,440 When the moment arrives I´ll be already prepared." 412 00:25:49,520 --> 00:25:52,520 And, well, as you love that person and you love him so much, 413 00:25:52,880 --> 00:25:57,160 you get to tell him that it´s OK to go away, to rest, 414 00:25:57,160 --> 00:26:01,880 that we are there with him and that we will always love him. 415 00:26:03,200 --> 00:26:06,640 In fact, when we were all there with him, 416 00:26:06,680 --> 00:26:10,000 we even gave him permission to leave. 417 00:26:10,240 --> 00:26:11,920 We told him he could go. 418 00:26:12,040 --> 00:26:15,000 I said: "Dad, you can go, is all done. 419 00:26:15,080 --> 00:26:19,680 We are all well and you did very well indeed." 420 00:26:20,680 --> 00:26:22,880 Well, I would like to comment a little bit, 421 00:26:23,200 --> 00:26:25,840 this legacy which left us the wife of a patient 422 00:26:25,880 --> 00:26:27,760 we were assisting in their home. 423 00:26:28,440 --> 00:26:31,600 He was a very young patient, thirty seven years old, 424 00:26:31,600 --> 00:26:33,400 he was diagnosed with liver cancer 425 00:26:33,960 --> 00:26:36,960 and his wife was accompanying him at all times. 426 00:26:37,200 --> 00:26:39,240 From the initial diagnosis to the end. 427 00:26:39,920 --> 00:26:43,360 She wanted to capture, with this drawing... 428 00:26:44,760 --> 00:26:48,320 the purple line is the line of the disease, 429 00:26:48,320 --> 00:26:50,120 from diagnosis to death 430 00:26:50,520 --> 00:26:53,160 and all these figures that appear below 431 00:26:53,160 --> 00:26:56,120 below the line of the disease, of death, 432 00:26:56,120 --> 00:26:59,160 those are all the health professionals 433 00:26:59,160 --> 00:27:01,720 who have accompanied the patient in the hospital, 434 00:27:01,960 --> 00:27:05,400 the teams of the psychologists, the surgeons. 435 00:27:05,720 --> 00:27:07,920 As soon as they entered 436 00:27:08,000 --> 00:27:10,040 the final phase of the illness, 437 00:27:10,080 --> 00:27:11,920 the palliative care team. 438 00:27:12,600 --> 00:27:16,080 Well, he finally decided 439 00:27:16,080 --> 00:27:19,040 to go to a hospital´s palliative care unit to die, 440 00:27:19,040 --> 00:27:21,040 and they are also reflected 441 00:27:21,040 --> 00:27:22,960 at the end of this disease, right? 442 00:27:23,200 --> 00:27:24,760 This is the patient, Carlos; he 443 00:27:24,760 --> 00:27:29,560 was accompanying Laura to walk along this disease, 444 00:27:29,800 --> 00:27:33,440 this arrival to the goal that was the end of his life, you see? 445 00:27:33,680 --> 00:27:37,680 With this drawing she wanted to thank us for all the support 446 00:27:37,680 --> 00:27:41,600 she had of our team and the other professionals 447 00:27:41,600 --> 00:27:44,560 who had accompanied her in this long process. 448 00:27:45,240 --> 00:27:48,960 "For all members of ESAD, you make easy the difficult." 449 00:27:49,040 --> 00:27:51,720 Which is one of our mottos, right? 450 00:27:51,960 --> 00:27:58,520 And after those days of living that agony with Carlos, 451 00:27:58,800 --> 00:28:02,040 of those so strong pains, and after those days, 452 00:28:02,040 --> 00:28:04,720 which were very grey and very dark for us, 453 00:28:04,880 --> 00:28:08,120 it was the arrival of the palliative cares team and suddenly, 454 00:28:08,120 --> 00:28:13,840 I had the feeling that the sun had arrived to the house, the light had arrived. 455 00:28:14,240 --> 00:28:16,600 The palliative care teams 456 00:28:17,360 --> 00:28:20,320 have served me wonderfully, 457 00:28:20,320 --> 00:28:23,760 incredibly, because they have been as... 458 00:28:24,280 --> 00:28:28,160 they are my therapeutic angels, really. 459 00:28:29,360 --> 00:28:33,160 ...because every time that the day arrived, it was a happy day for us. 460 00:28:34,960 --> 00:28:39,440 Moreover, there was a long time, fifteen days in which they would not come 461 00:28:39,440 --> 00:28:41,360 "How is it that you will not come in a fortnight? 462 00:28:41,360 --> 00:28:43,920 It cannot be, we need you every week, 463 00:28:44,160 --> 00:28:48,960 you give us an injection of life, an injection of hope..." 464 00:28:49,160 --> 00:28:51,920 It has to do with a feeling that you share blood and skin 465 00:28:51,920 --> 00:28:54,440 with other beings who shelter you when it is cold, 466 00:28:54,680 --> 00:28:56,640 who collect your tears in a jar 467 00:28:56,640 --> 00:28:58,560 to transform them into a healing potion. 468 00:28:58,840 --> 00:29:01,560 So thank you for enlightening us with a ray of hope, 469 00:29:01,760 --> 00:29:03,440 for making us know that a friendly arm 470 00:29:03,440 --> 00:29:05,960 rests in our shoulders to accompany us along the way, 471 00:29:06,200 --> 00:29:08,680 on the right track of a different and better world. 472 00:29:09,440 --> 00:29:10,680 So thank you very much. 473 00:29:14,000 --> 00:29:16,400 Man, now they do help me with tenderness! 474 00:29:19,440 --> 00:29:21,040 You can see how much they love me: 475 00:29:22,040 --> 00:29:28,480 I do not miss anything on the table. There´s nothing missing 476 00:29:29,480 --> 00:29:30,240 What did I need? 477 00:29:30,320 --> 00:29:33,480 I think I needed all what that people were giving me. 478 00:29:34,000 --> 00:29:35,360 They gave me everything. 479 00:29:36,440 --> 00:29:39,240 I needed internal tools which they gave me, 480 00:29:39,240 --> 00:29:42,160 I needed encouragement which they gave me, I needed venting 481 00:29:42,160 --> 00:29:46,120 and they would came to see me and I could talk and pour my heart out with them. 482 00:29:46,120 --> 00:29:47,880 Sometimes I was crying, sometimes laughing, 483 00:29:48,000 --> 00:29:51,960 sometimes I would share beautiful experiences... 484 00:29:52,320 --> 00:29:56,720 They are living a situation similar to yours with another relative of them 485 00:29:57,360 --> 00:29:59,880 who is in the same situation as yours, right? 486 00:30:00,320 --> 00:30:03,200 Then, a sort of complicity, 487 00:30:03,760 --> 00:30:08,560 a bond of friendship is created there. 488 00:30:08,560 --> 00:30:12,840 But it´s a bond of friendship which includes support, 489 00:30:13,240 --> 00:30:15,960 which includes them giving you encouragement, 490 00:30:17,080 --> 00:30:19,360 which includes that they will care about your relative. 491 00:30:20,440 --> 00:30:21,960 ...stories that are rediscovered, 492 00:30:22,920 --> 00:30:26,680 stories to which you find again a meaning. 493 00:30:27,960 --> 00:30:29,440 The encounters, right? 494 00:30:29,560 --> 00:30:31,640 Those are stories of encounters. 495 00:30:32,160 --> 00:30:34,080 When life turns out difficult, 496 00:30:34,240 --> 00:30:40,080 you meet again with the truth of those you have around, isn´t it? 497 00:30:40,520 --> 00:30:42,360 And why do we rediscover each other? 498 00:30:42,680 --> 00:30:45,680 Because there were many moments of being together, of speaking, 499 00:30:45,680 --> 00:30:47,480 of talking just us, 500 00:30:47,960 --> 00:30:51,560 of telling us things that maybe we had not said before. 501 00:30:51,680 --> 00:31:00,160 When a carer tells the patient: 502 00:31:00,680 --> 00:31:02,120 I would have chosen you again, 503 00:31:02,400 --> 00:31:06,120 even knowing all what we were going to go through together. 504 00:31:06,680 --> 00:31:10,560 Even knowing that, I would still choose 505 00:31:11,040 --> 00:31:13,840 to live this part of my life with you. 506 00:31:14,080 --> 00:31:15,880 He felt me very close to him; 507 00:31:16,760 --> 00:31:19,560 He felt my affection; he felt... he felt it. 508 00:31:20,080 --> 00:31:22,400 He would tell me: "I didn't know that you loved me so much." 509 00:31:23,240 --> 00:31:32,520 Every moment in which my son comes by, or my daughter-in-law, 510 00:31:34,640 --> 00:31:36,640 and I am in bed. 511 00:31:38,720 --> 00:31:41,200 And they don't know if I am sleeping or I am awake 512 00:31:41,960 --> 00:31:45,520 and he hugs me and he gives me a kiss. 513 00:31:47,640 --> 00:31:48,880 He gives me a kiss... 514 00:31:57,840 --> 00:31:59,080 Gosh!..., Oh, my!.... 515 00:32:03,640 --> 00:32:05,200 How much is that worth? 516 00:32:06,960 --> 00:32:08,360 Each person is different. 517 00:32:08,560 --> 00:32:11,120 So then, there is also an adaptation 518 00:32:11,200 --> 00:32:15,360 to a knowledge of that person´s needs. 519 00:32:15,520 --> 00:32:18,200 But you can always ask. 520 00:32:18,560 --> 00:32:21,120 Is there anything you think I can help you with? 521 00:32:21,960 --> 00:32:25,360 Just to accompany, being there, available. 522 00:32:25,800 --> 00:32:29,360 There may be a change and, sometimes, all that is needed 523 00:32:29,560 --> 00:32:35,320 is for the other person to know that you're there. 524 00:32:36,080 --> 00:32:44,320 I mean it´s not about saying anything, it´s about listening. 525 00:32:44,600 --> 00:32:47,120 He needed to be alone and to spent long hours just with himself, 526 00:32:47,440 --> 00:32:52,760 but it didn't bother him that I was there. 527 00:32:52,880 --> 00:32:57,280 That is, if I would come closer and we would just held hands 528 00:32:57,360 --> 00:33:01,000 and kept silent, he appreciated that very much. 529 00:33:01,640 --> 00:33:06,400 And more than just a sentence, I reminded him that, to see the sun every morning, 530 00:33:06,880 --> 00:33:10,200 and he would say: "Another day that I see the sun, another day has dawned". 531 00:33:10,920 --> 00:33:14,520 It is what I was telling you before, about the light being so important. 532 00:33:15,080 --> 00:33:19,040 The companion has an opportunity to reconcile 533 00:33:19,440 --> 00:33:22,480 and to close as well the stage lived next to the patient. 534 00:33:22,960 --> 00:33:28,520 So, I would like indeed to say that it is very important 535 00:33:28,520 --> 00:33:33,480 if you have the possibility to bid farewell to a person 536 00:33:33,480 --> 00:33:36,760 who you know is going to die, if you pass through this situation, 537 00:33:36,760 --> 00:33:38,320 try to say goodbye to him 538 00:33:38,440 --> 00:33:40,480 and try to communicate with him 539 00:33:40,680 --> 00:33:42,600 and with the rest of the family. 540 00:33:43,320 --> 00:33:45,640 I think it´s important because later on, when that person is missing, 541 00:33:45,720 --> 00:33:47,760 you´ll bear it much better. 542 00:33:48,400 --> 00:33:50,120 The companion may attend to the care 543 00:33:50,120 --> 00:33:51,920 of his or her own internal condition 544 00:33:52,000 --> 00:33:54,600 for this helps them to give the best of themselves. 545 00:33:54,680 --> 00:33:58,280 So those tools have been very helpful for me. 546 00:33:58,560 --> 00:34:02,760 All that work with the attention, with reconciliation. 547 00:34:03,160 --> 00:34:04,320 And at the end, 548 00:34:04,520 --> 00:34:07,200 all the work with ceremonies, with askings. 549 00:34:09,560 --> 00:34:12,239 ,,,to learn to remove drama off the situations. 550 00:34:12,960 --> 00:34:15,000 To learn how to laugh at a given moment, 551 00:34:15,280 --> 00:34:17,480 even at the adversity. 552 00:34:17,880 --> 00:34:19,760 One characteristic feature he had, 553 00:34:19,800 --> 00:34:21,199 and we all in the family have, 554 00:34:21,480 --> 00:34:22,440 is the sense of humour. 555 00:34:22,679 --> 00:34:25,120 And I find that very important in the process we have lived. 556 00:34:25,719 --> 00:34:28,040 It has been very important. 557 00:34:28,440 --> 00:34:29,960 To those who are in my situation? 558 00:34:30,880 --> 00:34:33,560 To get up in the morning, to laugh a lot, 559 00:34:34,000 --> 00:34:36,840 to tell jokes and to forget about what people might say. 560 00:34:37,520 --> 00:34:39,920 And then it´s all over. And the day I die, 561 00:34:39,960 --> 00:34:41,800 that they bury me so that it doesn't stink. 562 00:34:42,920 --> 00:34:45,880 The person is alive and needs people around them 563 00:34:46,280 --> 00:34:50,040 to treat them as someone alive, not as someone who is going to die. 564 00:34:51,159 --> 00:34:52,960 ...and then I go to the adult education centre, 565 00:34:53,040 --> 00:34:55,600 at three in the afternoon. I speak with one, talk to another. 566 00:34:55,679 --> 00:34:58,880 Today, as every Friday, when we leave the school 567 00:34:59,120 --> 00:35:01,040 we go to the bar, to our second home. 568 00:35:01,040 --> 00:35:02,200 And we have our coffee. 569 00:35:02,520 --> 00:35:05,520 We talk, we laugh, all that. And that´s how I spend the time. 570 00:35:06,440 --> 00:35:08,440 ...as pleasant as possible, 571 00:35:08,480 --> 00:35:11,800 in the sense of not forcing him to eat. 572 00:35:11,880 --> 00:35:13,600 If he wanted to eat, he would eat; 573 00:35:13,640 --> 00:35:15,040 if not, that´s OK, too. 574 00:35:15,320 --> 00:35:18,160 At the end it was very difficult for him to eat, to feed. 575 00:35:18,160 --> 00:35:20,800 And I would spend the days in the kitchen 576 00:35:20,800 --> 00:35:22,360 trying to prepare different dishes 577 00:35:22,400 --> 00:35:23,960 to see which one could be right for him... 578 00:35:23,960 --> 00:35:26,280 Instead of being more attentive 579 00:35:26,280 --> 00:35:27,720 to other things he was saying to me, 580 00:35:27,720 --> 00:35:33,200 or being more aware that he was tired, he was exhausted, 581 00:35:33,200 --> 00:35:37,760 he couldn´t take it anymore, I was wasting the time in other stories. 582 00:35:38,400 --> 00:35:43,680 This time, really, of conviviality, of sharing. 583 00:35:44,400 --> 00:35:48,640 This is a point, I would say, that helps. 584 00:35:50,560 --> 00:35:53,040 It is an opportunity for internal growth, 585 00:35:53,680 --> 00:35:58,200 for learning and for gaining in personal coherence. 586 00:36:10,320 --> 00:36:11,880 But when the illness stops us, 587 00:36:12,000 --> 00:36:14,440 suddenly many questions begin to arise. 588 00:36:14,480 --> 00:36:16,920 Questions that have to do with something as simple as: 589 00:36:17,280 --> 00:36:21,560 Why does this happen to me? Was this the right time? 590 00:36:21,560 --> 00:36:22,960 Because apparently it was at an age 591 00:36:22,960 --> 00:36:25,880 that maybe it did not correspond to be stopped by the disease 592 00:36:26,160 --> 00:36:27,680 or to be facing death. 593 00:36:28,200 --> 00:36:31,800 Or one wonders, if one has made a fairly good life, 594 00:36:31,800 --> 00:36:33,240 trying to do good around. 595 00:36:33,520 --> 00:36:35,640 And you feel life is treating you unfairly 596 00:36:35,640 --> 00:36:37,080 with these diseases. 597 00:36:37,760 --> 00:36:39,000 Well, we are at a stage 598 00:36:39,000 --> 00:36:41,360 where questions about meaning, 599 00:36:41,680 --> 00:36:43,440 about values, 600 00:36:43,880 --> 00:36:47,440 also questions as to whether I am at peace 601 00:36:47,640 --> 00:36:50,520 in my relationship with others, in my relationship with myself, 602 00:36:51,200 --> 00:36:53,160 or my relationship with a transcendent being. 603 00:36:53,800 --> 00:36:57,560 Anyone, regardless of their beliefs or atheism, 604 00:36:58,320 --> 00:37:00,760 may experience the necessity to reconcile 605 00:37:01,400 --> 00:37:03,000 or to give meaning to their lives. 606 00:37:03,720 --> 00:37:05,240 I would like to clarify the fact that the spiritual dimension 607 00:37:05,560 --> 00:37:07,880 does not always have a religious content. 608 00:37:08,440 --> 00:37:11,480 Moreover, there are often people 609 00:37:11,560 --> 00:37:13,520 who have a spiritual experience 610 00:37:13,760 --> 00:37:16,080 without having an approach to religion. 611 00:37:16,440 --> 00:37:20,720 We all have a spiritual view of things, 612 00:37:21,280 --> 00:37:22,960 although we do not always acknowledge them, 613 00:37:23,000 --> 00:37:24,640 or we don´t give them names, 614 00:37:25,160 --> 00:37:27,960 because those dimensions that we, all the human beings have, 615 00:37:28,280 --> 00:37:30,760 may appear, and we usually walk with them 616 00:37:30,840 --> 00:37:33,000 without being conscious of them, they are like the air, which we don´t see, either, 617 00:37:33,120 --> 00:37:35,240 but we know that it´s there and helps us to live. 618 00:37:35,880 --> 00:37:38,960 Prejudice or shyness when talking about these issues 619 00:37:39,040 --> 00:37:42,400 can block up something that is essential to address. 620 00:37:42,840 --> 00:37:45,040 Sometimes the problem is in the caregiver himself, 621 00:37:45,160 --> 00:37:46,880 who does not dare to talk about that, 622 00:37:47,040 --> 00:37:49,400 because he knows that it means entering in a scenario 623 00:37:49,440 --> 00:37:51,280 of deep communication and, sometimes, 624 00:37:51,280 --> 00:37:52,760 of painful communication, 625 00:37:53,040 --> 00:37:54,960 because it has to do with saying goodbye, 626 00:37:55,000 --> 00:37:56,560 it has to do with the end, isn´t it? 627 00:37:57,760 --> 00:38:00,640 It is not about making a therapy or giving spiritual direction. 628 00:38:01,320 --> 00:38:03,440 Well, it does not help me, you know? 629 00:38:04,240 --> 00:38:10,200 When people want to impose their beliefs, 630 00:38:10,680 --> 00:38:13,520 their way of seeing life. 631 00:38:14,440 --> 00:38:16,280 For example, religion. 632 00:38:16,640 --> 00:38:18,600 I am agnostic, for instance, 633 00:38:19,600 --> 00:38:23,880 and I have a lot of respect for those who have a religion. 634 00:38:23,920 --> 00:38:25,840 Much respect, to tell the truth, 635 00:38:26,360 --> 00:38:29,320 but I 'm not religious at all. 636 00:38:29,640 --> 00:38:34,600 I prefer to look at death, outside of what religion is. 637 00:38:34,920 --> 00:38:37,840 It is about accompanying the patients, 638 00:38:37,920 --> 00:38:41,920 while they find by themselves their own topics and plots. 639 00:38:43,200 --> 00:38:48,880 Then, there, he perceived the sun; he closed his eyes and said: 640 00:38:48,960 --> 00:38:54,480 "I'm on the beach of heaven, under the sun". 641 00:38:54,600 --> 00:38:57,280 That will help, mainly, to avoid blocking anything. 642 00:38:57,560 --> 00:39:01,520 This happens to us in the emotional issue and it happens as well in the spiritual issue. 643 00:39:01,600 --> 00:39:04,600 That is to say, the importance in the accompaniment 644 00:39:04,680 --> 00:39:08,160 of enabling the person to put words to all what they are living. 645 00:39:08,920 --> 00:39:11,400 To explore would be the key word of accompanying. 646 00:39:11,800 --> 00:39:14,840 Because exploration allows the doubts, the restlessness, the resources, 647 00:39:15,040 --> 00:39:18,520 the capacities, the fears, allows all that to come out. 648 00:39:18,840 --> 00:39:22,560 I believe that it is the most fundamental way to accompany. 649 00:39:24,400 --> 00:39:31,080 Victoria died and you can imagine, my pain was terrible, right? 650 00:39:31,720 --> 00:39:35,840 I was emotionally shattered because I would not stop crying, 651 00:39:36,960 --> 00:39:44,920 but then something amazing happened and it was that experience, 652 00:39:45,040 --> 00:39:47,560 the internal register I was talking about before, 653 00:39:47,560 --> 00:39:49,480 that register of people cuddling me. 654 00:39:49,560 --> 00:39:52,600 I felt cuddled, protected, 655 00:39:53,120 --> 00:39:55,920 but I felt that as if coming from the inside; 656 00:39:56,120 --> 00:40:00,040 something was accompanying me. 657 00:40:01,080 --> 00:40:03,240 I don´t know what... life. 658 00:40:03,520 --> 00:40:05,280 It was a sense of meaning, 659 00:40:06,080 --> 00:40:10,520 I felt that life was with me 660 00:40:10,680 --> 00:40:12,360 and that life continued with us 661 00:40:12,440 --> 00:40:14,360 and that life was supporting me at that time 662 00:40:14,360 --> 00:40:19,400 more than at any other time in my life 663 00:40:19,560 --> 00:40:20,880 or along this whole process. 664 00:40:22,760 --> 00:40:25,400 Many people believe they can not help their loved ones, 665 00:40:25,520 --> 00:40:28,560 because they don´t know what to do, or what to say, 666 00:40:28,560 --> 00:40:31,000 because their fears show up 667 00:40:31,040 --> 00:40:33,800 and they think they have no contribution to make. 668 00:40:34,040 --> 00:40:36,000 But the single fact of listening 669 00:40:36,080 --> 00:40:38,920 and accompanying is already a big help. 670 00:40:39,600 --> 00:40:41,120 When people feel, 671 00:40:41,200 --> 00:40:43,520 and when we feel heard, accepted, 672 00:40:43,600 --> 00:40:46,440 in those processes it is as if the spirit is liberated, 673 00:40:46,480 --> 00:40:48,160 as if the soul is liberated. 674 00:40:48,240 --> 00:40:51,280 And that is an authentic wonder. That is a gift. 675 00:40:51,400 --> 00:40:55,480 On the other hand, this is not just about the companion helping out. 676 00:40:56,000 --> 00:40:58,840 Proud. Mainly I feel proud of this last time, 677 00:40:59,000 --> 00:41:01,280 that I´d given them the confidence 678 00:41:01,320 --> 00:41:05,840 for them to stand this more calmly; 679 00:41:06,160 --> 00:41:11,440 for them no to have that fear of death. 680 00:41:11,720 --> 00:41:12,880 I know that for them, 681 00:41:12,880 --> 00:41:15,600 mainly for my children, it is very tough, 682 00:41:15,600 --> 00:41:17,480 because one is fifteen and the other twenty-one years old. 683 00:41:17,480 --> 00:41:22,040 But I know they will be strong 684 00:41:22,280 --> 00:41:24,760 and they will know how to face that, 685 00:41:24,760 --> 00:41:31,360 and they will know how to be at my side until the last minute; 686 00:41:31,560 --> 00:41:34,560 and me, I will thank them for that very, very much. 687 00:41:35,760 --> 00:41:37,160 It was amazing to see him, 688 00:41:37,320 --> 00:41:38,560 after the whole process, 689 00:41:38,600 --> 00:41:39,960 and after he already died. 690 00:41:40,360 --> 00:41:43,360 And he remained with a peace.. 691 00:41:43,760 --> 00:41:48,040 he stayed in peace, he kept a face of happiness, 692 00:41:48,120 --> 00:41:49,880 he had a happy face. 693 00:41:49,880 --> 00:41:53,640 He had a smile of peace and joy 694 00:41:54,240 --> 00:41:57,640 that made us all happy 695 00:41:57,760 --> 00:41:59,920 of having been able to carry out 696 00:42:00,040 --> 00:42:02,120 among all what he had wanted... 697 00:42:06,560 --> 00:42:07,760 The proximity of the end, 698 00:42:08,240 --> 00:42:10,640 usually involves a reconstruction of one's life; 699 00:42:11,400 --> 00:42:12,600 there is an evaluation of what has been done, 700 00:42:12,640 --> 00:42:13,800 of what has not been done. 701 00:42:14,680 --> 00:42:15,920 Finding the meaning, 702 00:42:16,120 --> 00:42:18,040 feeling that one´s life was worth of living, 703 00:42:18,640 --> 00:42:20,360 helps to re-evaluate one´s own biography 704 00:42:21,080 --> 00:42:22,920 relying on it´s most positive issues. 705 00:42:23,800 --> 00:42:29,440 ...to be able to relive, somehow, 706 00:42:29,480 --> 00:42:32,480 moments which have been happy. 707 00:42:32,840 --> 00:42:37,120 To be able to thank anyone, or no one, 708 00:42:37,920 --> 00:42:40,960 this time spent together. 709 00:42:41,520 --> 00:42:44,680 Recovering the stories of all those people 710 00:42:44,800 --> 00:42:46,680 who are around us 711 00:42:46,840 --> 00:42:50,320 and which are truly worth of listening, 712 00:42:51,160 --> 00:42:52,680 not just for the benefit 713 00:42:52,920 --> 00:42:54,400 of the other person, 714 00:42:54,400 --> 00:42:56,440 because you're helping them... 715 00:42:56,800 --> 00:42:59,640 so they can organise their memories 716 00:42:59,680 --> 00:43:03,160 and reconcile with many things, 717 00:43:03,160 --> 00:43:05,280 but for yourself as well... 718 00:43:07,000 --> 00:43:09,440 because they are passing on to you a story of life, 719 00:43:09,760 --> 00:43:11,520 that surely is going to help you 720 00:43:11,520 --> 00:43:13,120 in many occasions. 721 00:43:13,400 --> 00:43:16,000 In fact this is one of the most satisfactory 722 00:43:16,000 --> 00:43:18,000 experiences I´ve met. 723 00:43:18,040 --> 00:43:20,720 A part of that other person remains with you. 724 00:43:21,000 --> 00:43:22,600 The legacy is revised as well; 725 00:43:23,200 --> 00:43:25,080 what is left to others when leaving. 726 00:43:25,840 --> 00:43:28,520 What one has done can remain in the family, 727 00:43:28,680 --> 00:43:30,360 but it can also be 728 00:43:30,440 --> 00:43:32,600 an intellectual or artistic legacy, 729 00:43:32,680 --> 00:43:36,560 one of social advance or of a professional kind, etc... 730 00:43:36,800 --> 00:43:38,920 For instance, recently a person, 731 00:43:38,920 --> 00:43:40,720 who had worked a lot in research, was telling me. 732 00:43:41,040 --> 00:43:43,000 Knowing that he had made a little contribution to science 733 00:43:43,000 --> 00:43:45,680 implied that some part of him was going to stay 734 00:43:45,880 --> 00:43:47,520 when he was no longer here. 735 00:43:47,680 --> 00:43:49,000 He was, somehow, 736 00:43:49,000 --> 00:43:51,040 transcending his own experience 737 00:43:51,080 --> 00:43:52,560 beyond himself. 738 00:43:53,120 --> 00:43:54,960 This is also a key dimension. 739 00:43:55,160 --> 00:43:56,880 When you are caregivers you can tell 740 00:43:57,120 --> 00:43:58,480 the person who is sick: 741 00:43:58,800 --> 00:44:00,480 "Hey, even when you're not here, 742 00:44:00,680 --> 00:44:02,600 , you'll still be here for us in other ways, 743 00:44:02,680 --> 00:44:04,800 , you have been a treasure for us, 744 00:44:04,920 --> 00:44:06,120 you have been a gift". 745 00:44:06,800 --> 00:44:09,160 One helpful resource can be to elaborate a material, 746 00:44:09,280 --> 00:44:11,520 an album, a written testament, 747 00:44:12,080 --> 00:44:15,920 a video or a voice recording, 748 00:44:16,160 --> 00:44:19,680 that is to say, a physical object where to support the memories. 749 00:44:20,400 --> 00:44:24,200 He even made a video for the farewell. 750 00:44:24,600 --> 00:44:27,600 He put there his pictures, and pictures of us, 751 00:44:27,840 --> 00:44:29,920 and put his songs there too. 752 00:44:30,160 --> 00:44:35,720 And we were at the funeral home and we were with him, 753 00:44:36,000 --> 00:44:37,080 because I knew that Carlos, 754 00:44:37,080 --> 00:44:39,720 he was there with us, 755 00:44:40,520 --> 00:44:42,160 he was in his work which he had made. 756 00:44:42,160 --> 00:44:45,560 He didn't want tears to be there... 757 00:44:46,200 --> 00:44:49,120 The evocation and expression can also be supported 758 00:44:49,200 --> 00:44:52,400 in materials as photos, music... 759 00:44:54,560 --> 00:44:58,480 This photograph is one of the major supports 760 00:44:58,480 --> 00:45:02,360 for my father, for I put my intention 761 00:45:02,360 --> 00:45:05,280 in him leaning on the positive things and on the things he had built, 762 00:45:05,360 --> 00:45:07,720 and on what his purpose was. 763 00:45:07,840 --> 00:45:10,000 He had a clear purpose which was caring. 764 00:45:10,000 --> 00:45:12,680 He cared of plants, he cared of animals, cared of family, 765 00:45:12,680 --> 00:45:14,560 he cared of children, and he accomplished all that. 766 00:45:14,560 --> 00:45:17,840 So I said we should all support on the positive things. 767 00:45:17,920 --> 00:45:19,800 Because we had never thanked my father 768 00:45:19,880 --> 00:45:22,360 for everything he had done for us since my mother died. 769 00:45:22,880 --> 00:45:25,240 So we wrote this text you can see, which says: 770 00:45:25,320 --> 00:45:27,480 "Thanks for your effort, for being a fighter, 771 00:45:27,720 --> 00:45:31,480 for being a good model for us all, for getting ahead and taking care of this family, 772 00:45:31,600 --> 00:45:33,800 thanks for all this and so much more." 773 00:45:36,880 --> 00:45:39,480 The need to close the life cycle is experienced. 774 00:45:40,840 --> 00:45:43,160 Also reconciliation with other people 775 00:45:43,280 --> 00:45:45,640 especially people one loves, 776 00:45:45,840 --> 00:45:48,480 but mainly with life... The things one has done 777 00:45:48,600 --> 00:45:50,360 or what has been left undone, 778 00:45:50,640 --> 00:45:56,440 because sometimes... you feel like shifting priorities in those moments 779 00:45:56,880 --> 00:46:00,240 and you care more about more fundamental things. 780 00:46:00,520 --> 00:46:04,960 Then there are times when one feels that one didn´t ... 781 00:46:05,680 --> 00:46:08,040 that things one should have done had not been done, you see? 782 00:46:09,040 --> 00:46:11,440 But also to value what has been done. 783 00:46:11,560 --> 00:46:13,720 For the companion or the loved ones 784 00:46:13,760 --> 00:46:15,920 who accompany that sick person 785 00:46:16,280 --> 00:46:20,560 it is also important to say goodbye properly, and to fix things and to reconcile... 786 00:46:21,120 --> 00:46:23,840 Why? ... Because that life ends 787 00:46:23,920 --> 00:46:26,720 but the relationship with that person will continue; 788 00:46:26,800 --> 00:46:32,080 then also that helps the grieving process to be better. 789 00:46:32,200 --> 00:46:34,960 The only thing which is central, which is key, 790 00:46:34,960 --> 00:46:36,880 which is at the very core in people´s life, 791 00:46:37,160 --> 00:46:39,400 is to feel loved and to love. 792 00:46:39,920 --> 00:46:43,440 It is to be able to say: "It has been worth for me being with you and walking with you, 793 00:46:43,520 --> 00:46:45,680 making a journey together", isn't? 794 00:46:47,680 --> 00:46:51,720 The proximity of death and progressive detachment from life 795 00:46:52,200 --> 00:46:56,280 life can put the patient under conditions of deepening their experience 796 00:46:56,720 --> 00:47:00,640 of communication with the others, as well as on the meaning of life 797 00:47:00,640 --> 00:47:02,920 and the possibility of transcendence. 798 00:47:03,560 --> 00:47:05,480 I think that he was preparing himself for that moment, 799 00:47:05,520 --> 00:47:06,600 to face that moment. 800 00:47:06,760 --> 00:47:09,880 And that´s why I think that that silence, 801 00:47:10,000 --> 00:47:12,720 quite unlike him, he would not stop talking, that silence had to do with that, 802 00:47:15,000 --> 00:47:19,800 with accepting that he was going, that he was leaving. 803 00:47:21,360 --> 00:47:25,120 Because obviously, when there's a moment like that, 804 00:47:25,120 --> 00:47:28,480 in which you are expecting your end, you bring up many things. 805 00:47:28,600 --> 00:47:31,240 And he took out a lot from inside. 806 00:47:31,360 --> 00:47:33,800 But very, very rewarding. A lot. 807 00:47:34,520 --> 00:47:38,480 Death doesn't have to be necessarily terrifying or sad. 808 00:47:39,160 --> 00:47:41,280 Transforming the conditions, 809 00:47:41,360 --> 00:47:44,920 many people can get to accept it in deep peace. 810 00:47:45,360 --> 00:47:48,160 Well, along these two years, it has been an evolution, 811 00:47:48,800 --> 00:47:51,000 which I don´t believe it myself, of course. 812 00:47:51,160 --> 00:47:55,920 Because at first it was the shock, the impact of knowing 813 00:47:56,000 --> 00:48:00,880 that you are diagnosed with such a harsh illness. 814 00:48:02,760 --> 00:48:08,160 And after that it has been, in truth, in less than a year, 815 00:48:09,400 --> 00:48:13,600 passing to admit this disease naturally. 816 00:48:14,640 --> 00:48:18,480 With no nerves, 817 00:48:18,640 --> 00:48:26,240 no fear of what may come, nothing. On the contrary. 818 00:48:27,240 --> 00:48:29,200 Yes. He was completely calm. 819 00:48:29,480 --> 00:48:33,880 It was a completely light death. 820 00:48:34,680 --> 00:48:38,000 He made no gestures or anything like that. 821 00:48:38,520 --> 00:48:42,400 In a good way. Very calm. Grabbing him, we were grabbing him physically. 822 00:48:42,480 --> 00:48:47,240 I put a hand in his chest and grabbed one of his hands. 823 00:48:47,240 --> 00:48:48,520 My brother grabbed his other hand. 824 00:48:48,520 --> 00:48:54,600 We were all... well... accompanying him. 825 00:48:57,240 --> 00:49:01,640 And my sister said: "Dad, if you had known it was so easy, 826 00:49:01,760 --> 00:49:04,240 you would have surely left sooner". 827 00:49:09,880 --> 00:49:12,600 Mostly, what I see and what I feel of that moment 828 00:49:12,600 --> 00:49:15,640 is that he actually died as he wanted to. 829 00:49:17,200 --> 00:49:18,480 And he died peacefully. 830 00:49:19,160 --> 00:49:26,320 But dying peacefully is also something that was made very easy for him by the team, 831 00:49:26,600 --> 00:49:29,440 by being there, by knowing how to act at that moment. 832 00:49:29,800 --> 00:49:35,320 And he passed from life to death almost in nothing, 833 00:49:35,480 --> 00:49:37,280 in a sigh. 834 00:49:37,360 --> 00:49:42,800 He closed his eyes and that´s how it was. That´s how it happened. 835 00:49:56,680 --> 00:49:58,680 Accompanying him at the end of his life, 836 00:49:58,720 --> 00:50:01,160 was not just accompanying him in these last months, 837 00:50:01,240 --> 00:50:04,760 three in my case, but those last two years, all that time, you see? 838 00:50:05,240 --> 00:50:09,240 And I am really thankful to have had that opportunity, 839 00:50:09,240 --> 00:50:12,920 for having allowed myself to do the whole process in those two years. 840 00:50:13,000 --> 00:50:18,360 It is the confirmation by experience that there is something else 841 00:50:18,640 --> 00:50:22,720 than what we see with these eyes, 842 00:50:22,920 --> 00:50:25,440 than what I see with my own eyes, and what I feel with this... 843 00:50:27,320 --> 00:50:31,160 Perhaps transcendence and the experience of "us". 844 00:50:32,240 --> 00:50:38,280 I do not think this could have gone ahead without the support, 845 00:50:39,920 --> 00:50:46,400 the connection, the bonding between many people who have been accompanying me. 846 00:50:46,720 --> 00:50:50,160 And certainly I wouldn´t change that for anything. 847 00:50:50,960 --> 00:50:53,920 What's more, if I had to pass through it again, 848 00:50:53,920 --> 00:50:56,600 I imagine I would do that again. 849 00:50:58,440 --> 00:51:00,560 ...feeling well with myself. 850 00:51:01,200 --> 00:51:03,040 Saying: "It´s that I've done everything". 851 00:51:03,040 --> 00:51:05,640 That peace, that tranquility of saying: "It´s that I have done everything". 852 00:51:06,640 --> 00:51:10,240 I consider myself strong but I didn't think that I would be able to be so strong. 853 00:51:10,320 --> 00:51:13,880 But when something like this happens to you, 854 00:51:13,880 --> 00:51:18,240 you never know up to where you will get, how far you can arrive, you know? 855 00:51:18,960 --> 00:51:21,240 I came face to face with life. 856 00:51:21,360 --> 00:51:26,760 I came face to face with life and I said: 857 00:51:26,760 --> 00:51:31,800 "This is what I´ve been dealt to live with; s o let´s do it". 858 00:51:32,200 --> 00:51:36,120 Those have been very important moments in my life. 859 00:51:36,600 --> 00:51:39,480 Being present in the moment in which anything, 860 00:51:39,560 --> 00:51:41,440 just holding his hand, 861 00:51:41,600 --> 00:51:44,640 or just going for a walk in the hospital´s corridor, 862 00:51:44,800 --> 00:51:48,760 or whatever, was a very intense way of living things. 863 00:51:49,840 --> 00:51:51,640 ...the generosity of the people 864 00:51:51,640 --> 00:51:54,720 who have allowed me to accompany them in these moments. 865 00:51:55,840 --> 00:52:00,880 I think that it is really an act of generosity 866 00:52:01,080 --> 00:52:05,480 to allow me to participate in such important moment of the families. 867 00:52:06,240 --> 00:52:08,960 With each person who dies that I have treated, 868 00:52:09,120 --> 00:52:12,880 of course there's a part of myself that goes with that person. 869 00:52:13,600 --> 00:52:17,480 There's a part of me that may go, right? 870 00:52:18,280 --> 00:52:23,800 But, you know, what you have left in that moment, 871 00:52:24,480 --> 00:52:28,760 having been able to help that person; that is so great that I... 872 00:52:28,920 --> 00:52:36,080 ... I don't know, I used to think that there could not be many people in your heart, 873 00:52:38,280 --> 00:52:41,840 you see? I thought you could not love a lot of people. 874 00:52:42,240 --> 00:52:46,120 And the truth is that the more you love, 875 00:52:46,640 --> 00:52:49,480 more people fit into your heart. 876 00:52:50,120 --> 00:52:53,720 I decided, in its moment, to carry on doing this. 877 00:52:55,520 --> 00:52:58,400 I think it gives a lot of meaning to my life. 878 00:53:00,360 --> 00:53:05,400 I think that it confronts me less with my own death, 879 00:53:05,400 --> 00:53:07,360 although I think on my death. 880 00:53:07,400 --> 00:53:11,720 Being present many times at the death of patients, 881 00:53:12,920 --> 00:53:16,880 that is a school of life, it is not a school of death. 882 00:53:16,960 --> 00:53:18,680 It is a school of life. 883 00:53:19,280 --> 00:53:23,560 Because I do not deal with bodies, I am dealing with living people. 884 00:53:23,720 --> 00:53:29,040 When you continuously see people dying and you see how people say goodbye, 885 00:53:30,280 --> 00:53:33,800 how they treasure the details, the moments, the smiles. 886 00:53:34,280 --> 00:53:36,400 We do see all that in the patients, right? 887 00:53:36,880 --> 00:53:39,520 Then, we start appreciating the value, I am speaking for myself, 888 00:53:39,520 --> 00:53:41,400 the meaning of things 889 00:53:41,480 --> 00:53:44,320 and the relevance that some things have in my personal life. 890 00:53:45,000 --> 00:53:48,440 And the value of life, and the value of loving, 891 00:53:49,160 --> 00:53:51,240 that is what we learn here, 892 00:53:51,320 --> 00:53:52,800 and it is truly priceless. 893 00:53:53,200 --> 00:53:56,600 People say: "But, what a horror! How can you work in this? 894 00:53:56,600 --> 00:53:59,600 How you can you be doing this for fifteen years and be happy, 895 00:53:59,600 --> 00:54:02,920 and still go happy to work? If this is horrible! 896 00:54:03,320 --> 00:54:06,200 All day with death, all day with severe illness, 897 00:54:06,480 --> 00:54:08,280 all day with suffering..." 898 00:54:09,120 --> 00:54:12,960 And here, I would like to say indeed, that when you switch the focus, 899 00:54:13,360 --> 00:54:15,720 when you learn how not to see the patient 900 00:54:15,720 --> 00:54:18,240 as a person you have to cure, 901 00:54:18,320 --> 00:54:20,600 but as a person you have to help, 902 00:54:20,680 --> 00:54:22,640 to accompany at the end of life, 903 00:54:23,000 --> 00:54:25,880 and you see the usefulness of you being there, 904 00:54:26,240 --> 00:54:28,920 being there as a doctor and as a person as well, 905 00:54:28,920 --> 00:54:31,600 accompanying them, that is so rewarding, 906 00:54:31,680 --> 00:54:36,680 that it really helps you in making your day-to-day much more rewarding 907 00:54:36,680 --> 00:54:38,920 than many other medical specialties. 908 00:54:39,480 --> 00:54:41,000 And that is what I´ve tried to do. 909 00:54:41,080 --> 00:54:44,840 To live my life as best as possible, to have a family. 910 00:54:45,000 --> 00:54:49,840 To have a family that loves me and which I love. 911 00:54:50,600 --> 00:54:54,840 And I am more that satisfied in life with that. 912 00:54:56,480 --> 00:54:58,400 Satisfied, very satisfied. 913 00:54:59,160 --> 00:55:02,320 So to all of you who are in my circumstances, 914 00:55:02,360 --> 00:55:04,040 I give you a hug from here 915 00:55:04,560 --> 00:55:07,000 and I hope to receive yours too. 916 00:55:09,280 --> 00:55:11,560 What I mainly take with me are the smiles. 917 00:55:11,920 --> 00:55:15,400 Amid the sadness, amid the sorrow 918 00:55:15,600 --> 00:55:18,920 and amid the emotional pain, 919 00:55:19,040 --> 00:55:24,840 there is that point at which the connection appears and the smile appears. 920 00:55:25,520 --> 00:55:29,280 The serene smile of patients in many moments, 921 00:55:29,320 --> 00:55:30,840 even though it seems unbelievable. 922 00:55:30,920 --> 00:55:33,360 The most beautiful love declarations, 923 00:55:33,400 --> 00:55:39,360 I've seen them in couples who are bidding farewell, you know? 924 00:55:39,400 --> 00:55:45,880 Couples who are caring for each other in the last phase of illness.