WEBVTT 00:00:32.479 --> 00:00:35.880 From the very moment of birth, and even before, 00:00:36.040 --> 00:00:38.080 we are accompanied. 00:00:40.040 --> 00:00:41.400 We are accompanied by our families 00:00:42.040 --> 00:00:44.240 and usually by health professionals. 00:00:45.480 --> 00:00:48.720 The attachment begins, so necessary to survive; 00:00:49.080 --> 00:00:51.800 and so does detachment, giving way to a dance 00:00:51.840 --> 00:00:54.480 in which both will be more or less present 00:00:54.520 --> 00:00:57.400 throughout our lives. 00:00:58.240 --> 00:01:00.040 We are born very vulnerable, 00:01:00.520 --> 00:01:02.360 dependent on the surrounding world 00:01:02.880 --> 00:01:05.560 and thus our journey begins... 00:01:05.680 --> 00:01:08.080 learning with others and from others, 00:01:08.520 --> 00:01:12.680 collecting the history and building our own. 00:01:13.280 --> 00:01:15.800 The beginning and the end of life 00:01:15.960 --> 00:01:18.160 are situations of intense emotions 00:01:18.480 --> 00:01:20.680 and of a lot of physical frailty. 00:01:21.320 --> 00:01:23.840 Both experiences are of great transcendence 00:01:23.960 --> 00:01:26.280 for the people who share them. 00:01:32.400 --> 00:01:34.280 Our society has changed, 00:01:34.360 --> 00:01:37.360 we live more years and the final period lengthens. 00:01:38.200 --> 00:01:40.200 We are in an aged society 00:01:40.720 --> 00:01:48.280 and with such guidelines, ways and lifestyles, 00:01:48.880 --> 00:01:51.320 that there will increasingly be more people 00:01:51.720 --> 00:01:55.200 who are going to find themselves alone at the end of their lives. 00:01:55.640 --> 00:01:57.400 Since the middle of last century, 00:01:57.760 --> 00:02:00.680 health professionals like Elisabeth Kubler- Ross 00:02:01.040 --> 00:02:02.960 and Cicely Saunders, 00:02:03.320 --> 00:02:06.120 became aware that at the hospitals, 00:02:06.320 --> 00:02:10.400 terminal patients had needs which were not looked after. 00:02:11.280 --> 00:02:13.320 The professionals did not take care of them, 00:02:13.720 --> 00:02:16.560 considering that they could no longer cure them. 00:02:17.720 --> 00:02:19.480 When they became interested in the terminally ill patients, 00:02:20.000 --> 00:02:22.960 they found that their situation could be radically improved, 00:02:23.360 --> 00:02:25.280 both in the treatment of the pain 00:02:25.480 --> 00:02:29.040 as in addressing their emotional and spiritual needs. 00:02:30.000 --> 00:02:33.600 Since then, substantial professional knowledge has been accumulated 00:02:34.040 --> 00:02:37.400 in the field of palliative cares. 00:02:39.560 --> 00:02:43.440 In this documentary, we will try to convey this information 00:02:43.960 --> 00:02:48.240 as well as experiences and testimonies of people who have already been through it, 00:02:48.720 --> 00:02:52.280 so those experiences may become useful for those who accompany and care. 00:02:53.720 --> 00:02:57.280 This documentary is primarily intended to the companion. 00:02:58.480 --> 00:03:02.920 When cure turns out to be very unlikely, the priorities change. 00:03:03.560 --> 00:03:07.520 Affective and spiritual issues become the most important. 00:03:08.240 --> 00:03:10.640 And "even while it is true that the life time is shortened, 00:03:11.240 --> 00:03:13.000 it can also be widened". 00:03:13.600 --> 00:03:16.200 "You can live a lifetime in a few weeks". 00:03:17.280 --> 00:03:22.160 The patients often reappraise what is fundamental to their existence. 00:03:23.400 --> 00:03:25.320 They look forward to reconcile and to bid farewell. 00:03:26.320 --> 00:03:29.880 They need to settle down what they will be leaving to the others as a legacy 00:03:30.520 --> 00:03:33.680 and to consider, in accordance with their own convictions, 00:03:34.360 --> 00:03:37.600 the meaning of life and transcendence. 00:03:39.880 --> 00:03:41.640 The companions are also facing 00:03:41.920 --> 00:03:44.720 the main issues of their own lives 00:03:45.280 --> 00:03:48.120 and will have the opportunity to close 00:03:48.320 --> 00:03:51.440 in the best possible way their relationship with the patient. 00:04:01.600 --> 00:04:03.320 I took my mother down to the emergency ward. 00:04:03.640 --> 00:04:09.960 It was November 30th, and I was thinking that she was having a severe infection 00:04:10.440 --> 00:04:15.280 and that after stabilizing her, they would send her home to me. 00:04:16.000 --> 00:04:18.720 Being told that your mother has cancer is not the worst thing. 00:04:19.240 --> 00:04:23.160 For me, the worst was being told that on top of having that cancer, 00:04:23.680 --> 00:04:28.320 no one could do anything, anything at all for her. 00:04:28.800 --> 00:04:30.400 Nothing but to wait for death to come. 00:04:30.680 --> 00:04:33.800 Until they give you the diagnosis 00:04:33.800 --> 00:04:36.680 there is a lapse of time, some days of uncertainty, 00:04:36.960 --> 00:04:41.560 a time that is really very difficult to bear. 00:04:42.160 --> 00:04:47.400 So every day it was like waking up and to start thinking: 00:04:47.840 --> 00:04:51.680 Will it be today? Will it be tomorrow? 00:04:53.080 --> 00:04:59.720 And this uncertainty, it is as if it were corroding you in the inside. 00:05:00.200 --> 00:05:01.040 How can I tell you? 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? 00:05:05.280 --> 00:05:07.880 This is it, already. This is mine. 00:05:08.160 --> 00:05:09.920 I have it and this is the end of it. 00:05:10.600 --> 00:05:11.880 After the initial disorder, 00:05:12.360 --> 00:05:14.960 due to the impact of the news, when overcoming it, 00:05:15.640 --> 00:05:19.360 the moment arrives to organise ourselves and to make decisions. 00:05:20.320 --> 00:05:23.960 The whole family will be affected because it is necessary to assist the sick person 00:05:24.480 --> 00:05:28.280 and to replace them in whichever role they were previously doing. 00:05:28.920 --> 00:05:31.640 In the family, if one part moves, 00:05:32.080 --> 00:05:35.280 the whole group moves accordingly in order to compensate that. 00:05:35.800 --> 00:05:38.120 Where he wanted to be, how he wanted to be... 00:05:38.440 --> 00:05:40.800 We would talk with him and with that information, 00:05:41.240 --> 00:05:43.320 we would gather, the four siblings, and then we would decide. 00:05:44.160 --> 00:05:46.960 Some changes of roles become necessary because of the new situation. 00:05:47.520 --> 00:05:51.640 For example, someone who was not in charge of the house issues, 00:05:51.960 --> 00:05:55.080 has to start taking them in charge; if there are children, 00:05:55.600 --> 00:05:59.400 the children will also have to restructure their life a little bit. 00:06:00.040 --> 00:06:03.160 It is important that the patient shares all the information 00:06:03.480 --> 00:06:05.520 and that they can make their own decisions. 00:06:07.480 --> 00:06:09.400 Then indeed I knew it was going to be a hard impact to say: 00:06:09.680 --> 00:06:12.240 "You have cancer". 00:06:12.720 --> 00:06:15.240 My concerns were... Who is going to tell him? How do we tell him? 00:06:15.800 --> 00:06:17.920 Do we tell him the truth, or we rather don't? 00:06:18.280 --> 00:06:20.440 Eventually we agreed a bit grudgingly to do that, 00:06:20.800 --> 00:06:23.200 but afterwards we saw that it had been the best thing to do. 00:06:24.800 --> 00:06:27.640 It was also what he wanted, and so it was done. 00:06:28.160 --> 00:06:29.920 He wanted at all times to know the truth. 00:06:30.000 --> 00:06:35.520 The decisions we made, I dare to say 00:06:36.160 --> 00:06:38.720 that if not a hundred percent, 00:06:38.920 --> 00:06:40.560 at least ninety eight percent were made by my father. 00:06:41.160 --> 00:06:43.400 And I think that more and more, every day both patients and caregivers 00:06:44.080 --> 00:06:45.520 are being included 00:06:45.880 --> 00:06:49.760 to be able to participate in these decisions of rejecting treatment 00:06:50.080 --> 00:06:54.040 and preferring palliative approaches from other stages of the illness. 00:06:54.560 --> 00:06:58.080 It was at that moment when he said: "Look, I do not want any more chemo; 00:06:58.360 --> 00:07:00.080 if I can have radiotherapy, it´s ok. 00:07:00.080 --> 00:07:02.480 But not a second time. 00:07:02.720 --> 00:07:04.920 I can see by myself that chemo is not working for me. 00:07:04.920 --> 00:07:06.680 I don´t want to hear about chemo any more". 00:07:07.120 --> 00:07:08.800 So it was then when the oncologist said: 00:07:08.800 --> 00:07:10.120 "From here, I leave him in your hands". 00:07:10.520 --> 00:07:14.600 Through the Living Will they can record their decisions 00:07:14.880 --> 00:07:19.960 for a future moment in which they will not be able to express their preferences. 00:07:20.560 --> 00:07:24.760 The Advance Directives are what the patients want to be done 00:07:25.120 --> 00:07:27.720 when they cannot decide for themselves anymore. 00:07:28.520 --> 00:07:30.280 I would define the Living Will in a simple way 00:07:30.640 --> 00:07:33.880 as just a way to extend the autonomy 00:07:34.160 --> 00:07:36.480 and the capacity to decide of the sick person, 00:07:36.720 --> 00:07:39.640 for when they reach a moment in which they will no longer be able to decide. 00:07:40.000 --> 00:07:43.280 The Living Will is not meant for when one can express things. 00:07:43.280 --> 00:07:45.960 Although a person has made a Living Will 00:07:46.280 --> 00:07:49.360 it will always prevail what they are saying at the time. 00:07:49.680 --> 00:07:52.040 One of the decisions to be taken is 00:07:52.040 --> 00:07:55.840 whether at the last stage the patient will live in the hospital or at home. 00:07:56.520 --> 00:08:00.640 And of course one thing that gratified us, 00:08:01.040 --> 00:08:03.920 the nearest family, 00:08:04.400 --> 00:08:08.360 very much was to respect at all times what he told us he wanted. 00:08:08.720 --> 00:08:10.240 He wanted to die at home. 00:08:10.800 --> 00:08:12.400 And his wish was fulfilled. 00:08:12.880 --> 00:08:17.720 One can also think: "But that's not so easy... 00:08:17.720 --> 00:08:23.040 What if you can not control the illness and you have to hospitalise him?" 00:08:23.600 --> 00:08:27.600 But then a moment arrives in which we can not do anything. 00:08:27.640 --> 00:08:29.240 Why should he die in a hospital? 00:08:31.280 --> 00:08:33.200 And then another phase began in the summer, 00:08:33.200 --> 00:08:37.280 when the oncologist said that nothing else could be done. 00:08:37.520 --> 00:08:39.280 She told him she could no longer give him any more medication, 00:08:39.640 --> 00:08:41.200 because the illness was already advancing 00:08:41.520 --> 00:08:45.040 and he had to go with other palliatives practitioners, 00:08:45.040 --> 00:08:48.200 who would accompany him in the following process. 00:08:48.960 --> 00:08:54.120 And that's when the doctor decided 00:08:54.320 --> 00:08:58.280 that the best thing to do, because he will no longer have treatment, 00:08:58.520 --> 00:09:00.800 was to refer him to palliative care. 00:09:01.560 --> 00:09:07.480 Palliative care is care designed specifically 00:09:07.880 --> 00:09:14.800 to alleviate suffering, to improve quality of life, to give comfort 00:09:15.680 --> 00:09:21.200 to patients with very advanced chronic diseases, 00:09:21.520 --> 00:09:25.600 or in terminal phase, 00:09:25.800 --> 00:09:29.640 and to their families, friends and surrounding caregivers. 00:09:29.840 --> 00:09:31.640 There is not a precise moment. 00:09:31.920 --> 00:09:37.400 But the time arrives in which the possibilities of healing treatment 00:09:37.680 --> 00:09:39.720 disappear. 00:09:40.000 --> 00:09:41.000 In principle, it will be the medical staff 00:09:41.320 --> 00:09:42.600 who will request the intervention 00:09:42.960 --> 00:09:44.360 of a palliative care team. 00:09:44.760 --> 00:09:46.240 But this does not mean, that sometimes, 00:09:46.240 --> 00:09:48.760 even though the professional h as not demanded such services, 00:09:48.760 --> 00:09:50.520 if the family knows about it, 00:09:50.760 --> 00:09:52.720 they can contact us. 00:09:53.320 --> 00:09:55.600 In our case, we are a home care team. 00:09:55.880 --> 00:09:59.360 We work seeing the patients, assisting the patients 00:09:59.360 --> 00:10:01.040 primarily in their homes. 00:10:01.760 --> 00:10:04.320 The first necessity the family has about cares 00:10:04.440 --> 00:10:06.640 cares is to know that they can do it. 00:10:06.760 --> 00:10:08.120 Many things can be done 00:10:08.240 --> 00:10:10.520 and care is what would include all that what´s done; 00:10:10.880 --> 00:10:13.800 that is, giving tools to the family, 00:10:14.040 --> 00:10:16.840 giving tools to the patient so that they feel 00:10:16.920 --> 00:10:19.240 that there is a purpose in being there as they are. 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 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; 00:10:26.640 --> 00:10:27.720 that is caring. 00:10:28.120 --> 00:10:30.840 Teaching the family to prepare certain meals, 00:10:30.840 --> 00:10:32.480 not forcing the patient to eat; 00:10:32.520 --> 00:10:33.480 that is caring. 00:10:33.880 --> 00:10:35.960 Telling him: "You are doing it very well"; 00:10:36.240 --> 00:10:36.960 that is caring. 00:10:37.480 --> 00:10:39.960 The sanitary education in the most basic things, 00:10:40.280 --> 00:10:47.040 as it is the hygiene, the nursing, to learn how to move them in the bed. 00:10:47.280 --> 00:10:50.280 We teach them a very basic part 00:10:50.680 --> 00:10:53.800 and they usually teach us many more things, 00:10:54.080 --> 00:10:57.680 because who really knows the patient is the family. 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 00:11:01.600 --> 00:11:03.240 that makes you say: "God! We should apply for a patent for this!" 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. 00:11:08.440 --> 00:11:12.680 ...to know that if he has a fever raise, what should I do? 00:11:13.120 --> 00:11:18.280 If he has to be transported somewhere, who should I call? 00:11:18.680 --> 00:11:23.840 All that information they gave me, re-assured me a lot 00:11:23.960 --> 00:11:27.040 In helping to control the pain, 00:11:27.280 --> 00:11:29.400 their relatives have a dual role. 00:11:29.400 --> 00:11:33.360 There is the merely technical one of administering the medication, 00:11:33.600 --> 00:11:35.920 with the doses and guidelines 00:11:35.920 --> 00:11:38.280 given by the professionals in charge, 00:11:38.600 --> 00:11:40.920 and that usually people do quite well. 00:11:41.280 --> 00:11:45.200 But there are other non-pharmacological measures to be taken 00:11:45.520 --> 00:11:49.960 which help the patients to have good control of the pain. 00:11:50.240 --> 00:11:53.400 For example, to care that the patient is well rested, that they feel accompanied, 00:11:53.640 --> 00:11:56.360 that they can communicate with their relatives... 00:11:56.840 --> 00:12:00.480 The practice of palliative cares has advanced a lot 00:12:01.040 --> 00:12:04.440 and it helps the patients to live their final stage without pain 00:12:05.160 --> 00:12:06.920 and at the same time in a lucid state of mind. 00:12:07.960 --> 00:12:11.000 Even when there is already a cancer, a terminal illness, anyone, 00:12:12.000 --> 00:12:15.000 that doesn't mean the patient has to suffer pain; 00:12:15.480 --> 00:12:18.280 there are enough resources for the patient not to suffer. 00:12:19.480 --> 00:12:23.560 The truth is that the contribution of the topic of palliatives appeared to us as fundamental, 00:12:23.640 --> 00:12:25.960 the contribution in that moment, in how he was. 00:12:25.960 --> 00:12:29.200 Because he began to deal there with the whole issue of dying suffocated. 00:12:30.080 --> 00:12:35.960 The standard analgesic for patients at the end of the life is morphine. 00:12:36.400 --> 00:12:39.120 And with morphine, there is a whole black legend. 00:12:39.400 --> 00:12:45.880 Morphine leaves you drowsy, morphine takes lucidity away, 00:12:46.000 --> 00:12:49.560 morphine turns you into an addict... 00:12:49.760 --> 00:12:53.760 Well, I think all these things have to be banished. 00:12:54.640 --> 00:12:56.280 Because now we all know t 00:12:56.560 --> 00:13:00.960 that morphine used in patients with severe and intense pain 00:13:01.200 --> 00:13:02.600 does not take lucidity away. 00:13:03.400 --> 00:13:05.800 Palliative sedation is only applied 00:13:05.920 --> 00:13:09.280 as a last resource when pain is already un-treatable. 00:13:10.760 --> 00:13:19.160 Palliative sedation consists in administering enough sedative drugs 00:13:20.000 --> 00:13:24.400 with the intent to reduce the patient´s level of consciousness, 00:13:24.920 --> 00:13:30.200 enough to ensure comfort 00:13:30.600 --> 00:13:35.440 and control of the suffering, of pain, of breathlessness, of agitation. 00:13:35.640 --> 00:13:40.560 ...to treat symptoms that we can not control in another way, 00:13:40.640 --> 00:13:42.960 which we call refractory symptoms. 00:13:43.520 --> 00:13:47.520 And to be able to guarantee that people can die without pain, 00:13:47.720 --> 00:13:52.520 that they can die without agitation, that they can die without breathing difficulties. 00:13:52.600 --> 00:13:55.280 It's something that terrifies people, right? 00:13:56.240 --> 00:13:57.680 It is also very important 00:13:58.000 --> 00:14:00.760 to know that terminal sedation is not euthanasia, 00:14:01.000 --> 00:14:05.160 that terminal sedation is not to collaborate in assisted suicide. 00:14:05.440 --> 00:14:09.320 Terminal sedation is, as we are saying, a therapeutic tool. 00:14:09.880 --> 00:14:15.560 It is a process absolutely legal. 00:14:16.040 --> 00:14:17.480 These two circumstances 00:14:17.520 --> 00:14:21.560 are the most frequent to indicate (the need of) palliative sedation. 00:14:21.800 --> 00:14:24.720 We are usually at this point near the end of life 00:14:25.640 --> 00:14:31.560 life and we have exhausted as well other ways 00:14:31.760 --> 00:14:37.200 which don't imply a reduction of the patient's level of consciousness. 00:14:37.720 --> 00:14:41.440 Aside from the physical pain, they may suffer for different reasons, 00:14:41.560 --> 00:14:43.920 emotional ones, or of social origin... 00:14:44.200 --> 00:14:47.720 Therefore, care is not confined to alleviate physical pain; 00:14:48.000 --> 00:14:51.760 total pain corresponds with a "total medicine" 00:14:51.880 --> 00:14:54.360 which covers all needs. 00:14:54.640 --> 00:14:56.720 I understand palliative care 00:14:57.000 --> 00:14:59.880 as a person's fundamental right. 00:15:00.440 --> 00:15:05.080 Probably if we revise the Universal Declaration of Human Rights, 00:15:06.240 --> 00:15:11.520 they are all there, all these care needs in the end of life, 00:15:11.600 --> 00:15:14.760 in order to preserve the dignity and the meaning of life. 00:15:17.080 --> 00:15:19.480 The patients and their families go aboard 00:15:19.560 --> 00:15:22.880 in a process of great instability and emotional intensity. 00:15:24.240 --> 00:15:28.440 Well, sometimes it´s like a roller coaster all that, 00:15:29.160 --> 00:15:34.400 because those are very important as well as difficult moments. 00:15:34.960 --> 00:15:41.240 You feel rage, you feel guilt, then you think; "It´s no big deal, 00:15:41.440 --> 00:15:44.600 he´ll recover", you keep hope, 00:15:44.720 --> 00:15:48.600 and then perhaps ten minutes later the hope shatters 00:15:48.960 --> 00:15:51.880 and we are angry again. 00:15:52.600 --> 00:15:56.280 Some stages or steps that can be distinguished are fairly common, 00:15:56.880 --> 00:16:00.520 although each one lives them in their own way; variations can appear 00:16:00.800 --> 00:16:04.040 in the order, the duration or even the existence of some steps. 00:16:05.400 --> 00:16:10.520 The situation of caring for a patient with advanced disease 00:16:10.840 --> 00:16:12.960 is, for the family, for the caregiver, 00:16:12.960 --> 00:16:16.120 a situation of physical and emotional stress. 00:16:16.960 --> 00:16:20.200 Upon receiving the news, it is usual to begin by denying it, 00:16:20.680 --> 00:16:24.320 saying for instance: "There must be some mistake". 00:16:25.360 --> 00:16:27.160 It is important to find a way 00:16:27.160 --> 00:16:31.080 to communicate it to the patient with frankness, but tactfully. 00:16:31.720 --> 00:16:33.400 Since the beginning of the summer, 00:16:33.680 --> 00:16:37.800 the whole process lasted two months. At first he would not accept the situation. 00:16:38.920 --> 00:16:43.520 It was like the doctor was saying: "This is it"... and he: "No". 00:16:44.200 --> 00:16:47.800 We can understand this is a notice which is difficult to assume 00:16:48.360 --> 00:16:51.120 and denial does the function of a shock absorber, 00:16:51.440 --> 00:16:54.920 allowing distance until the patient 00:16:55.240 --> 00:16:58.840 is psychologically prepared to accept the new situation. 00:16:59.720 --> 00:17:02.000 The patient is entitled to the information, 00:17:02.600 --> 00:17:05.520 but is also entitled to not knowing, 00:17:05.800 --> 00:17:08.839 or to acknowledge according to a rhythm that is personal. 00:17:09.520 --> 00:17:13.000 The right to know does not entail an obligation to know. 00:17:13.000 --> 00:17:17.920 Another type of denial is one which occurs in the patient's environment 00:17:18.079 --> 00:17:20.920 to simulate that death will not happen. 00:17:21.599 --> 00:17:26.240 This is called "the conspiracy of silence". 00:17:28.680 --> 00:17:31.880 Many times, the family members, in an effort to protect, 00:17:32.240 --> 00:17:35.160 don't want to talk to the patient about the bad prognosis 00:17:35.440 --> 00:17:38.200 or the situation of the end of life. 00:17:38.480 --> 00:17:46.000 And this puts the patient into an isolation cage, 00:17:46.400 --> 00:17:50.400 which often conditions a worse symptomatic control. 00:17:50.800 --> 00:17:53.160 The fact that the patient can speak openly about things, 00:17:53.400 --> 00:17:56.720 facilitates a lot the control of symptoms in general 00:17:56.720 --> 00:17:58.480 and, in particular, the control of pain. 00:17:59.680 --> 00:18:01.120 I know that in many occasions, 00:18:01.400 --> 00:18:04.200 when there are serious health problems or at the end of life, 00:18:04.560 --> 00:18:06.000 you the caregivers try to be so careful 00:18:06.240 --> 00:18:09.680 with the sick persons, with the patients, 00:18:09.920 --> 00:18:11.600 that at the end you say: "We better don't tell them this 00:18:11.880 --> 00:18:13.080 so they are not going to be unsettled". 00:18:13.360 --> 00:18:15.560 What I would advise to you, is that with all freedom, 00:18:15.800 --> 00:18:19.160 you should be particularly attentive to their gestures, to the signs they send 00:18:19.440 --> 00:18:23.160 and from there, it would be about giving back in the form of questions, 00:18:23.440 --> 00:18:24.880 so they can feel that are being heard, 00:18:25.120 --> 00:18:27.880 the relevance, the centrality that all that has. 00:18:28.160 --> 00:18:32.400 To accept illness and death is not the same as resignation. 00:18:33.480 --> 00:18:37.280 Resignation is passive and paralyses in front of the suffering. 00:18:37.920 --> 00:18:42.080 But the acceptance of the fact that death is unavoidable 00:18:42.560 --> 00:18:44.600 opens the way to change things. 00:18:45.400 --> 00:18:48.160 And also, I tell to all those who are in such case, in my circumstances, 00:18:50.280 --> 00:18:51.920 That there´s nothing to worry about. 00:18:51.920 --> 00:18:55.800 And even if one wants to think otherwise, 00:18:56.080 --> 00:18:59.760 you will not have anything else, that´s the way things are. 00:19:00.600 --> 00:19:07.160 So, there´s no use in going over it again and again. 00:19:08.080 --> 00:19:11.720 Initially, the patient may react with anger. 00:19:12.400 --> 00:19:15.760 Frequently the question arises: "Why me?" 00:19:16.360 --> 00:19:18.800 Then, in that first moment, he didn't accept it. 00:19:19.200 --> 00:19:23.400 And some days of non acceptance came by, and anger, later. 00:19:23.960 --> 00:19:25.720 He started to get very angry. 00:19:25.880 --> 00:19:29.960 Anger can go against oneself, against medical personnel, 00:19:30.200 --> 00:19:33.560 against friends or companions, against God... 00:19:34.280 --> 00:19:36.560 The most normal thing is that they project the rage 00:19:36.560 --> 00:19:40.680 against the people who love them most and who more care of them. 00:19:41.600 --> 00:19:44.840 Impatience, frustration, irritability; 00:19:45.560 --> 00:19:49.200 this is what the relative is putting on with day by day. 00:19:49.880 --> 00:19:53.880 So it may be that the family becomes angry with the patient 00:19:54.800 --> 00:20:00.640 and this also creates an ambivalence that is a bit difficult. 00:20:00.800 --> 00:20:04.360 How will I possibly be angry with someone who is going to die? 00:20:04.600 --> 00:20:09.720 But of course, the person is irritated 00:20:09.800 --> 00:20:15.520 and it is difficult to be able to separate that this person who speaks, 00:20:16.160 --> 00:20:19.360 this is not him who´s speaking, but rather the illness. 00:20:20.320 --> 00:20:22.760 Setting aside some moments, because there were also some of those, of bad temper, 00:20:22.840 --> 00:20:25.320 in which he would answer me back in a bad way and such. 00:20:26.400 --> 00:20:29.640 But I did understand him, he was having enough; 00:20:29.680 --> 00:20:32.360 it was a fight against that which he had. 00:20:32.360 --> 00:20:37.200 So I did not feel that he was coming against me, not at any moment. 00:20:37.400 --> 00:20:41.120 It was a way to blow off steam, to vent. 00:20:41.640 --> 00:20:44.040 A way of saying: "But why has this happened to me? 00:20:44.040 --> 00:20:45.640 Why am I locked up here? Why am I suffering this?" 00:20:45.760 --> 00:20:48.320 It is just that, they are blowing off steam; 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. 00:20:54.480 --> 00:20:56.200 There´s no need to revise the cares, 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. 00:21:01.840 --> 00:21:04.760 But he was aware so he would back down 00:21:05.280 --> 00:21:07.120 and apologise constantly. 00:21:07.120 --> 00:21:10.320 "I did not want (to say that), but it´s that I'm nervous sometimes, 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. 00:21:17.720 --> 00:21:22.400 Then, that´s what I would have wanted for me 00:21:23.200 --> 00:21:27.400 and what I wanted for me is what I tried to give him. 00:21:29.320 --> 00:21:33.520 And there can also come out emotions or feelings, 00:21:33.920 --> 00:21:36.000 which sometimes make you feel guilty, you see? 00:21:36.000 --> 00:21:38.440 When you see the person who is suffering a lot, 00:21:38.680 --> 00:21:42.240 you may want him to die so he will not suffer anymore. 00:21:42.240 --> 00:21:44.320 And then later you can feel bad about that. 00:21:45.040 --> 00:21:50.760 It is actually quite fair to wish for that person not to suffer, 00:21:51.760 --> 00:21:54.080 but this kind of feelings 00:21:54.160 --> 00:21:56.840 maybe are not quite socially accepted 00:21:59.240 --> 00:22:02.920 and therefore they will generate some guilt. 00:22:03.440 --> 00:22:07.760 One of the most inappropriate or less practical feelings, 00:22:08.120 --> 00:22:09.520 to say it somehow, 00:22:09.600 --> 00:22:11.800 is the feeling of guilt. 00:22:12.000 --> 00:22:15.680 And we will only be able to give quality cares 00:22:15.680 --> 00:22:18.880 if we are well ourselves. 00:22:20.160 --> 00:22:21.240 Negotiation: 00:22:22.480 --> 00:22:24.200 an internal dialogue takes place, 00:22:24.800 --> 00:22:27.160 as trying to negotiate their situation. 00:22:27.880 --> 00:22:32.400 This is usually related with pending matters and farewells. 00:22:32.760 --> 00:22:36.840 But once the wedding was over he said: 00:22:36.920 --> 00:22:39.680 "I have already kept up, so from now on, whatever comes to me..." 00:22:40.160 --> 00:22:42.480 He even told me that: "Whatever comes to me, 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, 00:22:46.440 --> 00:22:49.560 if this it is my end I no longer care about it. 00:22:50.040 --> 00:22:53.920 I have already kept up with my daughter, with all of you, 00:22:54.880 --> 00:22:57.440 I did not want to spoil this beautiful day for my daughter." 00:23:00.760 --> 00:23:02.920 When accepting that the situation is unavoidable, 00:23:03.000 --> 00:23:05.440 a state of sort of depression comes up 00:23:05.880 --> 00:23:08.440 which often can not be avoided. 00:23:09.920 --> 00:23:14.360 If the pain is allowed to be expressed, that helps for the final acceptance. 00:23:15.680 --> 00:23:18.440 In this sense, there are not useful at all 00:23:18.800 --> 00:23:20.960 any forced positive attitudes 00:23:21.480 --> 00:23:23.200 or pretending with the intention to cheer up. 00:23:23.920 --> 00:23:26.400 Many times few words are needed, 00:23:27.000 --> 00:23:32.480 but what can always help is to be there, available. 00:23:33.520 --> 00:23:35.320 We have spoken all these things. 00:23:35.640 --> 00:23:37.840 We talked about our fears, 00:23:38.280 --> 00:23:39.720 about all our concerns. 00:23:40.600 --> 00:23:43.080 We have all opened our hearts... 00:23:44.480 --> 00:23:46.880 It is truly important to open the hearts... 00:23:46.960 --> 00:23:49.840 What I mean is, there are issues that sometimes overwhelm us, 00:23:50.360 --> 00:23:53.600 that seem so important, and at the end are not important at all. 00:23:53.880 --> 00:23:56.640 ...this need to talk, to be heard without judgment 00:23:56.640 --> 00:23:58.680 what he was saying. 00:23:59.000 --> 00:24:06.360 That was also a very strong need I saw in him. 00:24:06.840 --> 00:24:11.120 The detachment is the rest at the end of the journey. 00:24:11.200 --> 00:24:14.520 Moreover, when the time will arrive... 00:24:15.320 --> 00:24:17.960 I think I'll even be happy 00:24:19.200 --> 00:24:21.160 when the time comes. 00:24:22.080 --> 00:24:26.000 Because I know that I will rest as well. 00:24:26.900 --> 00:24:29.360 The patient reduces his activity to the minimum, 00:24:29.480 --> 00:24:33.680 hardly speaks and loses interest for what surrounds him 00:24:33.840 --> 00:24:37.280 He wants to be alone or with much reduced company. 00:24:37.920 --> 00:24:41.160 This happens because he is preparing to leave; 00:24:41.880 --> 00:24:45.080 and the companions may suffer when feeling ignored 00:24:45.560 --> 00:24:48.440 if they don´t understand this stage of detachment. 00:24:48.440 --> 00:24:50.480 He needs to go into himself 00:24:51.000 --> 00:24:55.640 and he needs to start caring less for those he has around. 00:24:55.800 --> 00:24:58.880 That sometimes makes the caregivers feel bad. 00:24:59.280 --> 00:25:01.920 Makes them feel that they are not as useful, 00:25:01.920 --> 00:25:05.440 or makes them feel that the person they love so much 00:25:05.680 --> 00:25:08.280 no longer needs them as much. 00:25:10.240 --> 00:25:11.560 It is necessary to let them go. 00:25:12.040 --> 00:25:13.720 And for letting them go it is also necessary 00:25:13.720 --> 00:25:16.560 to allow them this detachment 00:25:17.760 --> 00:25:19.640 To experience that their loved ones 00:25:19.840 --> 00:25:21.320 don't accept their death, 00:25:21.680 --> 00:25:23.800 can be for the patients a cause for distress. 00:25:24.560 --> 00:25:27.000 It is important to "give them permission" to leave. 00:25:27.880 --> 00:25:31.760 What it is necessary to do is to let go of the other person. 00:25:32.880 --> 00:25:37.160 And then, to let go calmly as well, is important for those who remain. 00:25:39.800 --> 00:25:43.080 And he told us many times: "I don't want you to cry for me, 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. 00:25:47.120 --> 00:25:49.440 When the moment arrives I´ll be already prepared." 00:25:49.520 --> 00:25:52.520 And, well, as you love that person and you love him so much, 00:25:52.880 --> 00:25:57.160 you get to tell him that it´s OK to go away, to rest, 00:25:57.160 --> 00:26:01.880 that we are there with him and that we will always love him. 00:26:03.200 --> 00:26:06.640 In fact, when we were all there with him, 00:26:06.680 --> 00:26:10.000 we even gave him permission to leave. 00:26:10.240 --> 00:26:11.920 We told him he could go. 00:26:12.040 --> 00:26:15.000 I said: "Dad, you can go, is all done. 00:26:15.080 --> 00:26:19.680 We are all well and you did very well indeed." 00:26:20.680 --> 00:26:22.880 Well, I would like to comment a little bit, 00:26:23.200 --> 00:26:25.840 this legacy which left us the wife of a patient 00:26:25.880 --> 00:26:27.760 we were assisting in their home. 00:26:28.440 --> 00:26:31.600 He was a very young patient, thirty seven years old, 00:26:31.600 --> 00:26:33.400 he was diagnosed with liver cancer 00:26:33.960 --> 00:26:36.960 and his wife was accompanying him at all times. 00:26:37.200 --> 00:26:39.240 From the initial diagnosis to the end. 00:26:39.920 --> 00:26:43.360 She wanted to capture, with this drawing... 00:26:44.760 --> 00:26:48.320 the purple line is the line of the disease, 00:26:48.320 --> 00:26:50.120 from diagnosis to death 00:26:50.520 --> 00:26:53.160 and all these figures that appear below 00:26:53.160 --> 00:26:56.120 below the line of the disease, of death, 00:26:56.120 --> 00:26:59.160 those are all the health professionals 00:26:59.160 --> 00:27:01.720 who have accompanied the patient in the hospital, 00:27:01.960 --> 00:27:05.400 the teams of the psychologists, the surgeons. 00:27:05.720 --> 00:27:07.920 As soon as they entered 00:27:08.000 --> 00:27:10.040 the final phase of the illness, 00:27:10.080 --> 00:27:11.920 the palliative care team. 00:27:12.600 --> 00:27:16.080 Well, he finally decided 00:27:16.080 --> 00:27:19.040 to go to a hospital´s palliative care unit to die, 00:27:19.040 --> 00:27:21.040 and they are also reflected 00:27:21.040 --> 00:27:22.960 at the end of this disease, right? 00:27:23.200 --> 00:27:24.760 This is the patient, Carlos; he 00:27:24.760 --> 00:27:29.560 was accompanying Laura to walk along this disease, 00:27:29.800 --> 00:27:33.440 this arrival to the goal that was the end of his life, you see? 00:27:33.680 --> 00:27:37.680 With this drawing she wanted to thank us for all the support 00:27:37.680 --> 00:27:41.600 she had of our team and the other professionals 00:27:41.600 --> 00:27:44.560 who had accompanied her in this long process. 00:27:45.240 --> 00:27:48.960 "For all members of ESAD, you make easy the difficult." 00:27:49.040 --> 00:27:51.720 Which is one of our mottos, right? 00:27:51.960 --> 00:27:58.520 And after those days of living that agony with Carlos, 00:27:58.800 --> 00:28:02.040 of those so strong pains, and after those days, 00:28:02.040 --> 00:28:04.720 which were very grey and very dark for us, 00:28:04.880 --> 00:28:08.120 it was the arrival of the palliative cares team and suddenly, 00:28:08.120 --> 00:28:13.840 I had the feeling that the sun had arrived to the house, the light had arrived. 00:28:14.240 --> 00:28:16.600 The palliative care teams 00:28:17.360 --> 00:28:20.320 have served me wonderfully, 00:28:20.320 --> 00:28:23.760 incredibly, because they have been as... 00:28:24.280 --> 00:28:28.160 they are my therapeutic angels, really. 00:28:29.360 --> 00:28:33.160 ...because every time that the day arrived, it was a happy day for us. 00:28:34.960 --> 00:28:39.440 Moreover, there was a long time, fifteen days in which they would not come 00:28:39.440 --> 00:28:41.360 "How is it that you will not come in a fortnight? 00:28:41.360 --> 00:28:43.920 It cannot be, we need you every week, 00:28:44.160 --> 00:28:48.960 you give us an injection of life, an injection of hope..." 00:28:49.160 --> 00:28:51.920 It has to do with a feeling that you share blood and skin 00:28:51.920 --> 00:28:54.440 with other beings who shelter you when it is cold, 00:28:54.680 --> 00:28:56.640 who collect your tears in a jar 00:28:56.640 --> 00:28:58.560 to transform them into a healing potion. 00:28:58.840 --> 00:29:01.560 So thank you for enlightening us with a ray of hope, 00:29:01.760 --> 00:29:03.440 for making us know that a friendly arm 00:29:03.440 --> 00:29:05.960 rests in our shoulders to accompany us along the way, 00:29:06.200 --> 00:29:08.680 on the right track of a different and better world. 00:29:09.440 --> 00:29:10.680 So thank you very much. 00:29:14.000 --> 00:29:16.400 Man, now they do help me with tenderness! 00:29:19.440 --> 00:29:21.040 You can see how much they love me: 00:29:22.040 --> 00:29:28.480 I do not miss anything on the table. There´s nothing missing 00:29:29.480 --> 00:29:30.240 What did I need? 00:29:30.320 --> 00:29:33.480 I think I needed all what that people were giving me. 00:29:34.000 --> 00:29:35.360 They gave me everything. 00:29:36.440 --> 00:29:39.240 I needed internal tools which they gave me, 00:29:39.240 --> 00:29:42.160 I needed encouragement which they gave me, I needed venting 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. 00:29:46.120 --> 00:29:47.880 Sometimes I was crying, sometimes laughing, 00:29:48.000 --> 00:29:51.960 sometimes I would share beautiful experiences... 00:29:52.320 --> 00:29:56.720 They are living a situation similar to yours with another relative of them 00:29:57.360 --> 00:29:59.880 who is in the same situation as yours, right? 00:30:00.320 --> 00:30:03.200 Then, a sort of complicity, 00:30:03.760 --> 00:30:08.560 a bond of friendship is created there. 00:30:08.560 --> 00:30:12.840 But it´s a bond of friendship which includes support, 00:30:13.240 --> 00:30:15.960 which includes them giving you encouragement, 00:30:17.080 --> 00:30:19.360 which includes that they will care about your relative. 00:30:20.440 --> 00:30:21.960 ...stories that are rediscovered, 00:30:22.920 --> 00:30:26.680 stories to which you find again a meaning. 00:30:27.960 --> 00:30:29.440 The encounters, right? 00:30:29.560 --> 00:30:31.640 Those are stories of encounters. 00:30:32.160 --> 00:30:34.080 When life turns out difficult, 00:30:34.240 --> 00:30:40.080 you meet again with the truth of those you have around, isn´t it? 00:30:40.520 --> 00:30:42.360 And why do we rediscover each other? 00:30:42.680 --> 00:30:45.680 Because there were many moments of being together, of speaking, 00:30:45.680 --> 00:30:47.480 of talking just us, 00:30:47.960 --> 00:30:51.560 of telling us things that maybe we had not said before. 00:30:51.680 --> 00:31:00.160 When a carer tells the patient: 00:31:00.680 --> 00:31:02.120 I would have chosen you again, 00:31:02.400 --> 00:31:06.120 even knowing all what we were going to go through together. 00:31:06.680 --> 00:31:10.560 Even knowing that, I would still choose 00:31:11.040 --> 00:31:13.840 to live this part of my life with you. 00:31:14.080 --> 00:31:15.880 He felt me very close to him; 00:31:16.760 --> 00:31:19.560 He felt my affection; he felt... he felt it. 00:31:20.080 --> 00:31:22.400 He would tell me: "I didn't know that you loved me so much." 00:31:23.240 --> 00:31:32.520 Every moment in which my son comes by, or my daughter-in-law, 00:31:34.640 --> 00:31:36.640 and I am in bed. 00:31:38.720 --> 00:31:41.200 And they don't know if I am sleeping or I am awake 00:31:41.960 --> 00:31:45.520 and he hugs me and he gives me a kiss. 00:31:47.640 --> 00:31:48.880 He gives me a kiss... 00:31:57.840 --> 00:31:59.080 Gosh!..., Oh, my!.... 00:32:03.640 --> 00:32:05.200 How much is that worth? 00:32:06.960 --> 00:32:08.360 Each person is different. 00:32:08.560 --> 00:32:11.120 So then, there is also an adaptation 00:32:11.200 --> 00:32:15.360 to a knowledge of that person´s needs. 00:32:15.520 --> 00:32:18.200 But you can always ask. 00:32:18.560 --> 00:32:21.120 Is there anything you think I can help you with? 00:32:21.960 --> 00:32:25.360 Just to accompany, being there, available. 00:32:25.800 --> 00:32:29.360 There may be a change and, sometimes, all that is needed 00:32:29.560 --> 00:32:35.320 is for the other person to know that you're there. 00:32:36.080 --> 00:32:44.320 I mean it´s not about saying anything, it´s about listening. 00:32:44.600 --> 00:32:47.120 He needed to be alone and to spent long hours just with himself, 00:32:47.440 --> 00:32:52.760 but it didn't bother him that I was there. 00:32:52.880 --> 00:32:57.280 That is, if I would come closer and we would just held hands 00:32:57.360 --> 00:33:01.000 and kept silent, he appreciated that very much. 00:33:01.640 --> 00:33:06.400 And more than just a sentence, I reminded him that, to see the sun every morning, 00:33:06.880 --> 00:33:10.200 and he would say: "Another day that I see the sun, another day has dawned". 00:33:10.920 --> 00:33:14.520 It is what I was telling you before, about the light being so important. 00:33:15.080 --> 00:33:19.040 The companion has an opportunity to reconcile 00:33:19.440 --> 00:33:22.480 and to close as well the stage lived next to the patient. 00:33:22.960 --> 00:33:28.520 So, I would like indeed to say that it is very important 00:33:28.520 --> 00:33:33.480 if you have the possibility to bid farewell to a person 00:33:33.480 --> 00:33:36.760 who you know is going to die, if you pass through this situation, 00:33:36.760 --> 00:33:38.320 try to say goodbye to him 00:33:38.440 --> 00:33:40.480 and try to communicate with him 00:33:40.680 --> 00:33:42.600 and with the rest of the family. 00:33:43.320 --> 00:33:45.640 I think it´s important because later on, when that person is missing, 00:33:45.720 --> 00:33:47.760 you´ll bear it much better. 00:33:48.400 --> 00:33:50.120 The companion may attend to the care 00:33:50.120 --> 00:33:51.920 of his or her own internal condition 00:33:52.000 --> 00:33:54.600 for this helps them to give the best of themselves. 00:33:54.680 --> 00:33:58.280 So those tools have been very helpful for me. 00:33:58.560 --> 00:34:02.760 All that work with the attention, with reconciliation. 00:34:03.160 --> 00:34:04.320 And at the end, 00:34:04.520 --> 00:34:07.200 all the work with ceremonies, with askings. 00:34:09.560 --> 00:34:12.239 ,,,to learn to remove drama off the situations. 00:34:12.960 --> 00:34:15.000 To learn how to laugh at a given moment, 00:34:15.280 --> 00:34:17.480 even at the adversity. 00:34:17.880 --> 00:34:19.760 One characteristic feature he had, 00:34:19.800 --> 00:34:21.199 and we all in the family have, 00:34:21.480 --> 00:34:22.440 is the sense of humour. 00:34:22.679 --> 00:34:25.120 And I find that very important in the process we have lived. 00:34:25.719 --> 00:34:28.040 It has been very important. 00:34:28.440 --> 00:34:29.960 To those who are in my situation? 00:34:30.880 --> 00:34:33.560 To get up in the morning, to laugh a lot, 00:34:34.000 --> 00:34:36.840 to tell jokes and to forget about what people might say. 00:34:37.520 --> 00:34:39.920 And then it´s all over. And the day I die, 00:34:39.960 --> 00:34:41.800 that they bury me so that it doesn't stink. 00:34:42.920 --> 00:34:45.880 The person is alive and needs people around them 00:34:46.280 --> 00:34:50.040 to treat them as someone alive, not as someone who is going to die. 00:34:51.159 --> 00:34:52.960 ...and then I go to the adult education centre, 00:34:53.040 --> 00:34:55.600 at three in the afternoon. I speak with one, talk to another. 00:34:55.679 --> 00:34:58.880 Today, as every Friday, when we leave the school 00:34:59.120 --> 00:35:01.040 we go to the bar, to our second home. 00:35:01.040 --> 00:35:02.200 And we have our coffee. 00:35:02.520 --> 00:35:05.520 We talk, we laugh, all that. And that´s how I spend the time. 00:35:06.440 --> 00:35:08.440 ...as pleasant as possible, 00:35:08.480 --> 00:35:11.800 in the sense of not forcing him to eat. 00:35:11.880 --> 00:35:13.600 If he wanted to eat, he would eat; 00:35:13.640 --> 00:35:15.040 if not, that´s OK, too. 00:35:15.320 --> 00:35:18.160 At the end it was very difficult for him to eat, to feed. 00:35:18.160 --> 00:35:20.800 And I would spend the days in the kitchen 00:35:20.800 --> 00:35:22.360 trying to prepare different dishes 00:35:22.400 --> 00:35:23.960 to see which one could be right for him... 00:35:23.960 --> 00:35:26.280 Instead of being more attentive 00:35:26.280 --> 00:35:27.720 to other things he was saying to me, 00:35:27.720 --> 00:35:33.200 or being more aware that he was tired, he was exhausted, 00:35:33.200 --> 00:35:37.760 he couldn´t take it anymore, I was wasting the time in other stories. 00:35:38.400 --> 00:35:43.680 This time, really, of conviviality, of sharing. 00:35:44.400 --> 00:35:48.640 This is a point, I would say, that helps. 00:35:50.560 --> 00:35:53.040 It is an opportunity for internal growth, 00:35:53.680 --> 00:35:58.200 for learning and for gaining in personal coherence. 00:36:10.320 --> 00:36:11.880 But when the illness stops us, 00:36:12.000 --> 00:36:14.440 suddenly many questions begin to arise. 00:36:14.480 --> 00:36:16.920 Questions that have to do with something as simple as: 00:36:17.280 --> 00:36:21.560 Why does this happen to me? Was this the right time? 00:36:21.560 --> 00:36:22.960 Because apparently it was at an age 00:36:22.960 --> 00:36:25.880 that maybe it did not correspond to be stopped by the disease 00:36:26.160 --> 00:36:27.680 or to be facing death. 00:36:28.200 --> 00:36:31.800 Or one wonders, if one has made a fairly good life, 00:36:31.800 --> 00:36:33.240 trying to do good around. 00:36:33.520 --> 00:36:35.640 And you feel life is treating you unfairly 00:36:35.640 --> 00:36:37.080 with these diseases. 00:36:37.760 --> 00:36:39.000 Well, we are at a stage 00:36:39.000 --> 00:36:41.360 where questions about meaning, 00:36:41.680 --> 00:36:43.440 about values, 00:36:43.880 --> 00:36:47.440 also questions as to whether I am at peace 00:36:47.640 --> 00:36:50.520 in my relationship with others, in my relationship with myself, 00:36:51.200 --> 00:36:53.160 or my relationship with a transcendent being. 00:36:53.800 --> 00:36:57.560 Anyone, regardless of their beliefs or atheism, 00:36:58.320 --> 00:37:00.760 may experience the necessity to reconcile 00:37:01.400 --> 00:37:03.000 or to give meaning to their lives. 00:37:03.720 --> 00:37:05.240 I would like to clarify the fact that the spiritual dimension 00:37:05.560 --> 00:37:07.880 does not always have a religious content. 00:37:08.440 --> 00:37:11.480 Moreover, there are often people 00:37:11.560 --> 00:37:13.520 who have a spiritual experience 00:37:13.760 --> 00:37:16.080 without having an approach to religion. 00:37:16.440 --> 00:37:20.720 We all have a spiritual view of things, 00:37:21.280 --> 00:37:22.960 although we do not always acknowledge them, 00:37:23.000 --> 00:37:24.640 or we don´t give them names, 00:37:25.160 --> 00:37:27.960 because those dimensions that we, all the human beings have, 00:37:28.280 --> 00:37:30.760 may appear, and we usually walk with them 00:37:30.840 --> 00:37:33.000 without being conscious of them, they are like the air, which we don´t see, either, 00:37:33.120 --> 00:37:35.240 but we know that it´s there and helps us to live. 00:37:35.880 --> 00:37:38.960 Prejudice or shyness when talking about these issues 00:37:39.040 --> 00:37:42.400 can block up something that is essential to address. 00:37:42.840 --> 00:37:45.040 Sometimes the problem is in the caregiver himself, 00:37:45.160 --> 00:37:46.880 who does not dare to talk about that, 00:37:47.040 --> 00:37:49.400 because he knows that it means entering in a scenario 00:37:49.440 --> 00:37:51.280 of deep communication and, sometimes, 00:37:51.280 --> 00:37:52.760 of painful communication, 00:37:53.040 --> 00:37:54.960 because it has to do with saying goodbye, 00:37:55.000 --> 00:37:56.560 it has to do with the end, isn´t it? 00:37:57.760 --> 00:38:00.640 It is not about making a therapy or giving spiritual direction. 00:38:01.320 --> 00:38:03.440 Well, it does not help me, you know? 00:38:04.240 --> 00:38:10.200 When people want to impose their beliefs, 00:38:10.680 --> 00:38:13.520 their way of seeing life. 00:38:14.440 --> 00:38:16.280 For example, religion. 00:38:16.640 --> 00:38:18.600 I am agnostic, for instance, 00:38:19.600 --> 00:38:23.880 and I have a lot of respect for those who have a religion. 00:38:23.920 --> 00:38:25.840 Much respect, to tell the truth, 00:38:26.360 --> 00:38:29.320 but I 'm not religious at all. 00:38:29.640 --> 00:38:34.600 I prefer to look at death, outside of what religion is. 00:38:34.920 --> 00:38:37.840 It is about accompanying the patients, 00:38:37.920 --> 00:38:41.920 while they find by themselves their own topics and plots. 00:38:43.200 --> 00:38:48.880 Then, there, he perceived the sun; he closed his eyes and said: 00:38:48.960 --> 00:38:54.480 "I'm on the beach of heaven, under the sun". 00:38:54.600 --> 00:38:57.280 That will help, mainly, to avoid blocking anything. 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. 00:39:01.600 --> 00:39:04.600 That is to say, the importance in the accompaniment 00:39:04.680 --> 00:39:08.160 of enabling the person to put words to all what they are living. 00:39:08.920 --> 00:39:11.400 To explore would be the key word of accompanying. 00:39:11.800 --> 00:39:14.840 Because exploration allows the doubts, the restlessness, the resources, 00:39:15.040 --> 00:39:18.520 the capacities, the fears, allows all that to come out. 00:39:18.840 --> 00:39:22.560 I believe that it is the most fundamental way to accompany. 00:39:24.400 --> 00:39:31.080 Victoria died and you can imagine, my pain was terrible, right? 00:39:31.720 --> 00:39:35.840 I was emotionally shattered because I would not stop crying, 00:39:36.960 --> 00:39:44.920 but then something amazing happened and it was that experience, 00:39:45.040 --> 00:39:47.560 the internal register I was talking about before, 00:39:47.560 --> 00:39:49.480 that register of people cuddling me. 00:39:49.560 --> 00:39:52.600 I felt cuddled, protected, 00:39:53.120 --> 00:39:55.920 but I felt that as if coming from the inside; 00:39:56.120 --> 00:40:00.040 something was accompanying me. 00:40:01.080 --> 00:40:03.240 I don´t know what... life. 00:40:03.520 --> 00:40:05.280 It was a sense of meaning, 00:40:06.080 --> 00:40:10.520 I felt that life was with me 00:40:10.680 --> 00:40:12.360 and that life continued with us 00:40:12.440 --> 00:40:14.360 and that life was supporting me at that time 00:40:14.360 --> 00:40:19.400 more than at any other time in my life 00:40:19.560 --> 00:40:20.880 or along this whole process. 00:40:22.760 --> 00:40:25.400 Many people believe they can not help their loved ones, 00:40:25.520 --> 00:40:28.560 because they don´t know what to do, or what to say, 00:40:28.560 --> 00:40:31.000 because their fears show up 00:40:31.040 --> 00:40:33.800 and they think they have no contribution to make. 00:40:34.040 --> 00:40:36.000 But the single fact of listening 00:40:36.080 --> 00:40:38.920 and accompanying is already a big help. 00:40:39.600 --> 00:40:41.120 When people feel, 00:40:41.200 --> 00:40:43.520 and when we feel heard, accepted, 00:40:43.600 --> 00:40:46.440 in those processes it is as if the spirit is liberated, 00:40:46.480 --> 00:40:48.160 as if the soul is liberated. 00:40:48.240 --> 00:40:51.280 And that is an authentic wonder. That is a gift. 00:40:51.400 --> 00:40:55.480 On the other hand, this is not just about the companion helping out. 00:40:56.000 --> 00:40:58.840 Proud. Mainly I feel proud of this last time, 00:40:59.000 --> 00:41:01.280 that I´d given them the confidence 00:41:01.320 --> 00:41:05.840 for them to stand this more calmly; 00:41:06.160 --> 00:41:11.440 for them no to have that fear of death. 00:41:11.720 --> 00:41:12.880 I know that for them, 00:41:12.880 --> 00:41:15.600 mainly for my children, it is very tough, 00:41:15.600 --> 00:41:17.480 because one is fifteen and the other twenty-one years old. 00:41:17.480 --> 00:41:22.040 But I know they will be strong 00:41:22.280 --> 00:41:24.760 and they will know how to face that, 00:41:24.760 --> 00:41:31.360 and they will know how to be at my side until the last minute; 00:41:31.560 --> 00:41:34.560 and me, I will thank them for that very, very much. 00:41:35.760 --> 00:41:37.160 It was amazing to see him, 00:41:37.320 --> 00:41:38.560 after the whole process, 00:41:38.600 --> 00:41:39.960 and after he already died. 00:41:40.360 --> 00:41:43.360 And he remained with a peace.. 00:41:43.760 --> 00:41:48.040 he stayed in peace, he kept a face of happiness, 00:41:48.120 --> 00:41:49.880 he had a happy face. 00:41:49.880 --> 00:41:53.640 He had a smile of peace and joy 00:41:54.240 --> 00:41:57.640 that made us all happy 00:41:57.760 --> 00:41:59.920 of having been able to carry out 00:42:00.040 --> 00:42:02.120 among all what he had wanted... 00:42:06.560 --> 00:42:07.760 The proximity of the end, 00:42:08.240 --> 00:42:10.640 usually involves a reconstruction of one's life; 00:42:11.400 --> 00:42:12.600 there is an evaluation of what has been done, 00:42:12.640 --> 00:42:13.800 of what has not been done. 00:42:14.680 --> 00:42:15.920 Finding the meaning, 00:42:16.120 --> 00:42:18.040 feeling that one´s life was worth of living, 00:42:18.640 --> 00:42:20.360 helps to re-evaluate one´s own biography 00:42:21.080 --> 00:42:22.920 relying on it´s most positive issues. 00:42:23.800 --> 00:42:29.440 ...to be able to relive, somehow, 00:42:29.480 --> 00:42:32.480 moments which have been happy. 00:42:32.840 --> 00:42:37.120 To be able to thank anyone, or no one, 00:42:37.920 --> 00:42:40.960 this time spent together. 00:42:41.520 --> 00:42:44.680 Recovering the stories of all those people 00:42:44.800 --> 00:42:46.680 who are around us 00:42:46.840 --> 00:42:50.320 and which are truly worth of listening, 00:42:51.160 --> 00:42:52.680 not just for the benefit 00:42:52.920 --> 00:42:54.400 of the other person, 00:42:54.400 --> 00:42:56.440 because you're helping them... 00:42:56.800 --> 00:42:59.640 so they can organise their memories 00:42:59.680 --> 00:43:03.160 and reconcile with many things, 00:43:03.160 --> 00:43:05.280 but for yourself as well... 00:43:07.000 --> 00:43:09.440 because they are passing on to you a story of life, 00:43:09.760 --> 00:43:11.520 that surely is going to help you 00:43:11.520 --> 00:43:13.120 in many occasions. 00:43:13.400 --> 00:43:16.000 In fact this is one of the most satisfactory 00:43:16.000 --> 00:43:18.000 experiences I´ve met. 00:43:18.040 --> 00:43:20.720 A part of that other person remains with you. 00:43:21.000 --> 00:43:22.600 The legacy is revised as well; 00:43:23.200 --> 00:43:25.080 what is left to others when leaving. 00:43:25.840 --> 00:43:28.520 What one has done can remain in the family, 00:43:28.680 --> 00:43:30.360 but it can also be 00:43:30.440 --> 00:43:32.600 an intellectual or artistic legacy, 00:43:32.680 --> 00:43:36.560 one of social advance or of a professional kind, etc... 00:43:36.800 --> 00:43:38.920 For instance, recently a person, 00:43:38.920 --> 00:43:40.720 who had worked a lot in research, was telling me. 00:43:41.040 --> 00:43:43.000 Knowing that he had made a little contribution to science 00:43:43.000 --> 00:43:45.680 implied that some part of him was going to stay 00:43:45.880 --> 00:43:47.520 when he was no longer here. 00:43:47.680 --> 00:43:49.000 He was, somehow, 00:43:49.000 --> 00:43:51.040 transcending his own experience 00:43:51.080 --> 00:43:52.560 beyond himself. 00:43:53.120 --> 00:43:54.960 This is also a key dimension. 00:43:55.160 --> 00:43:56.880 When you are caregivers you can tell 00:43:57.120 --> 00:43:58.480 the person who is sick: 00:43:58.800 --> 00:44:00.480 "Hey, even when you're not here, 00:44:00.680 --> 00:44:02.600 , you'll still be here for us in other ways, 00:44:02.680 --> 00:44:04.800 , you have been a treasure for us, 00:44:04.920 --> 00:44:06.120 you have been a gift". 00:44:06.800 --> 00:44:09.160 One helpful resource can be to elaborate a material, 00:44:09.280 --> 00:44:11.520 an album, a written testament, 00:44:12.080 --> 00:44:15.920 a video or a voice recording, 00:44:16.160 --> 00:44:19.680 that is to say, a physical object where to support the memories. 00:44:20.400 --> 00:44:24.200 He even made a video for the farewell. 00:44:24.600 --> 00:44:27.600 He put there his pictures, and pictures of us, 00:44:27.840 --> 00:44:29.920 and put his songs there too. 00:44:30.160 --> 00:44:35.720 And we were at the funeral home and we were with him, 00:44:36.000 --> 00:44:37.080 because I knew that Carlos, 00:44:37.080 --> 00:44:39.720 he was there with us, 00:44:40.520 --> 00:44:42.160 he was in his work which he had made. 00:44:42.160 --> 00:44:45.560 He didn't want tears to be there... 00:44:46.200 --> 00:44:49.120 The evocation and expression can also be supported 00:44:49.200 --> 00:44:52.400 in materials as photos, music... 00:44:54.560 --> 00:44:58.480 This photograph is one of the major supports 00:44:58.480 --> 00:45:02.360 for my father, for I put my intention 00:45:02.360 --> 00:45:05.280 in him leaning on the positive things and on the things he had built, 00:45:05.360 --> 00:45:07.720 and on what his purpose was. 00:45:07.840 --> 00:45:10.000 He had a clear purpose which was caring. 00:45:10.000 --> 00:45:12.680 He cared of plants, he cared of animals, cared of family, 00:45:12.680 --> 00:45:14.560 he cared of children, and he accomplished all that. 00:45:14.560 --> 00:45:17.840 So I said we should all support on the positive things. 00:45:17.920 --> 00:45:19.800 Because we had never thanked my father 00:45:19.880 --> 00:45:22.360 for everything he had done for us since my mother died. 00:45:22.880 --> 00:45:25.240 So we wrote this text you can see, which says: 00:45:25.320 --> 00:45:27.480 "Thanks for your effort, for being a fighter, 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, 00:45:31.600 --> 00:45:33.800 thanks for all this and so much more." 00:45:36.880 --> 00:45:39.480 The need to close the life cycle is experienced. 00:45:40.840 --> 00:45:43.160 Also reconciliation with other people 00:45:43.280 --> 00:45:45.640 especially people one loves, 00:45:45.840 --> 00:45:48.480 but mainly with life... The things one has done 00:45:48.600 --> 00:45:50.360 or what has been left undone, 00:45:50.640 --> 00:45:56.440 because sometimes... you feel like shifting priorities in those moments 00:45:56.880 --> 00:46:00.240 and you care more about more fundamental things. 00:46:00.520 --> 00:46:04.960 Then there are times when one feels that one didn´t ... 00:46:05.680 --> 00:46:08.040 that things one should have done had not been done, you see? 00:46:09.040 --> 00:46:11.440 But also to value what has been done. 00:46:11.560 --> 00:46:13.720 For the companion or the loved ones 00:46:13.760 --> 00:46:15.920 who accompany that sick person 00:46:16.280 --> 00:46:20.560 it is also important to say goodbye properly, and to fix things and to reconcile... 00:46:21.120 --> 00:46:23.840 Why? ... Because that life ends 00:46:23.920 --> 00:46:26.720 but the relationship with that person will continue; 00:46:26.800 --> 00:46:32.080 then also that helps the grieving process to be better. 00:46:32.200 --> 00:46:34.960 The only thing which is central, which is key, 00:46:34.960 --> 00:46:36.880 which is at the very core in people´s life, 00:46:37.160 --> 00:46:39.400 is to feel loved and to love. 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, 00:46:43.520 --> 00:46:45.680 making a journey together", isn't? 00:46:47.680 --> 00:46:51.720 The proximity of death and progressive detachment from life 00:46:52.200 --> 00:46:56.280 life can put the patient under conditions of deepening their experience 00:46:56.720 --> 00:47:00.640 of communication with the others, as well as on the meaning of life 00:47:00.640 --> 00:47:02.920 and the possibility of transcendence. 00:47:03.560 --> 00:47:05.480 I think that he was preparing himself for that moment, 00:47:05.520 --> 00:47:06.600 to face that moment. 00:47:06.760 --> 00:47:09.880 And that´s why I think that that silence, 00:47:10.000 --> 00:47:12.720 quite unlike him, he would not stop talking, that silence had to do with that, 00:47:15.000 --> 00:47:19.800 with accepting that he was going, that he was leaving. 00:47:21.360 --> 00:47:25.120 Because obviously, when there's a moment like that, 00:47:25.120 --> 00:47:28.480 in which you are expecting your end, you bring up many things. 00:47:28.600 --> 00:47:31.240 And he took out a lot from inside. 00:47:31.360 --> 00:47:33.800 But very, very rewarding. A lot. 00:47:34.520 --> 00:47:38.480 Death doesn't have to be necessarily terrifying or sad. 00:47:39.160 --> 00:47:41.280 Transforming the conditions, 00:47:41.360 --> 00:47:44.920 many people can get to accept it in deep peace. 00:47:45.360 --> 00:47:48.160 Well, along these two years, it has been an evolution, 00:47:48.800 --> 00:47:51.000 which I don´t believe it myself, of course. 00:47:51.160 --> 00:47:55.920 Because at first it was the shock, the impact of knowing 00:47:56.000 --> 00:48:00.880 that you are diagnosed with such a harsh illness. 00:48:02.760 --> 00:48:08.160 And after that it has been, in truth, in less than a year, 00:48:09.400 --> 00:48:13.600 passing to admit this disease naturally. 00:48:14.640 --> 00:48:18.480 With no nerves, 00:48:18.640 --> 00:48:26.240 no fear of what may come, nothing. On the contrary. 00:48:27.240 --> 00:48:29.200 Yes. He was completely calm. 00:48:29.480 --> 00:48:33.880 It was a completely light death. 00:48:34.680 --> 00:48:38.000 He made no gestures or anything like that. 00:48:38.520 --> 00:48:42.400 In a good way. Very calm. Grabbing him, we were grabbing him physically. 00:48:42.480 --> 00:48:47.240 I put a hand in his chest and grabbed one of his hands. 00:48:47.240 --> 00:48:48.520 My brother grabbed his other hand. 00:48:48.520 --> 00:48:54.600 We were all... well... accompanying him. 00:48:57.240 --> 00:49:01.640 And my sister said: "Dad, if you had known it was so easy, 00:49:01.760 --> 00:49:04.240 you would have surely left sooner". 00:49:09.880 --> 00:49:12.600 Mostly, what I see and what I feel of that moment 00:49:12.600 --> 00:49:15.640 is that he actually died as he wanted to. 00:49:17.200 --> 00:49:18.480 And he died peacefully. 00:49:19.160 --> 00:49:26.320 But dying peacefully is also something that was made very easy for him by the team, 00:49:26.600 --> 00:49:29.440 by being there, by knowing how to act at that moment. 00:49:29.800 --> 00:49:35.320 And he passed from life to death almost in nothing, 00:49:35.480 --> 00:49:37.280 in a sigh. 00:49:37.360 --> 00:49:42.800 He closed his eyes and that´s how it was. That´s how it happened. 00:49:56.680 --> 00:49:58.680 Accompanying him at the end of his life, 00:49:58.720 --> 00:50:01.160 was not just accompanying him in these last months, 00:50:01.240 --> 00:50:04.760 three in my case, but those last two years, all that time, you see? 00:50:05.240 --> 00:50:09.240 And I am really thankful to have had that opportunity, 00:50:09.240 --> 00:50:12.920 for having allowed myself to do the whole process in those two years. 00:50:13.000 --> 00:50:18.360 It is the confirmation by experience that there is something else 00:50:18.640 --> 00:50:22.720 than what we see with these eyes, 00:50:22.920 --> 00:50:25.440 than what I see with my own eyes, and what I feel with this... 00:50:27.320 --> 00:50:31.160 Perhaps transcendence and the experience of "us". 00:50:32.240 --> 00:50:38.280 I do not think this could have gone ahead without the support, 00:50:39.920 --> 00:50:46.400 the connection, the bonding between many people who have been accompanying me. 00:50:46.720 --> 00:50:50.160 And certainly I wouldn´t change that for anything. 00:50:50.960 --> 00:50:53.920 What's more, if I had to pass through it again, 00:50:53.920 --> 00:50:56.600 I imagine I would do that again. 00:50:58.440 --> 00:51:00.560 ...feeling well with myself. 00:51:01.200 --> 00:51:03.040 Saying: "It´s that I've done everything". 00:51:03.040 --> 00:51:05.640 That peace, that tranquility of saying: "It´s that I have done everything". 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. 00:51:10.320 --> 00:51:13.880 But when something like this happens to you, 00:51:13.880 --> 00:51:18.240 you never know up to where you will get, how far you can arrive, you know? 00:51:18.960 --> 00:51:21.240 I came face to face with life. 00:51:21.360 --> 00:51:26.760 I came face to face with life and I said: 00:51:26.760 --> 00:51:31.800 "This is what I´ve been dealt to live with; s o let´s do it". 00:51:32.200 --> 00:51:36.120 Those have been very important moments in my life. 00:51:36.600 --> 00:51:39.480 Being present in the moment in which anything, 00:51:39.560 --> 00:51:41.440 just holding his hand, 00:51:41.600 --> 00:51:44.640 or just going for a walk in the hospital´s corridor, 00:51:44.800 --> 00:51:48.760 or whatever, was a very intense way of living things. 00:51:49.840 --> 00:51:51.640 ...the generosity of the people 00:51:51.640 --> 00:51:54.720 who have allowed me to accompany them in these moments. 00:51:55.840 --> 00:52:00.880 I think that it is really an act of generosity 00:52:01.080 --> 00:52:05.480 to allow me to participate in such important moment of the families. 00:52:06.240 --> 00:52:08.960 With each person who dies that I have treated, 00:52:09.120 --> 00:52:12.880 of course there's a part of myself that goes with that person. 00:52:13.600 --> 00:52:17.480 There's a part of me that may go, right? 00:52:18.280 --> 00:52:23.800 But, you know, what you have left in that moment, 00:52:24.480 --> 00:52:28.760 having been able to help that person; that is so great that I... 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, 00:52:38.280 --> 00:52:41.840 you see? I thought you could not love a lot of people. 00:52:42.240 --> 00:52:46.120 And the truth is that the more you love, 00:52:46.640 --> 00:52:49.480 more people fit into your heart. 00:52:50.120 --> 00:52:53.720 I decided, in its moment, to carry on doing this. 00:52:55.520 --> 00:52:58.400 I think it gives a lot of meaning to my life. 00:53:00.360 --> 00:53:05.400 I think that it confronts me less with my own death, 00:53:05.400 --> 00:53:07.360 although I think on my death. 00:53:07.400 --> 00:53:11.720 Being present many times at the death of patients, 00:53:12.920 --> 00:53:16.880 that is a school of life, it is not a school of death. 00:53:16.960 --> 00:53:18.680 It is a school of life. 00:53:19.280 --> 00:53:23.560 Because I do not deal with bodies, I am dealing with living people. 00:53:23.720 --> 00:53:29.040 When you continuously see people dying and you see how people say goodbye, 00:53:30.280 --> 00:53:33.800 how they treasure the details, the moments, the smiles. 00:53:34.280 --> 00:53:36.400 We do see all that in the patients, right? 00:53:36.880 --> 00:53:39.520 Then, we start appreciating the value, I am speaking for myself, 00:53:39.520 --> 00:53:41.400 the meaning of things 00:53:41.480 --> 00:53:44.320 and the relevance that some things have in my personal life. 00:53:45.000 --> 00:53:48.440 And the value of life, and the value of loving, 00:53:49.160 --> 00:53:51.240 that is what we learn here, 00:53:51.320 --> 00:53:52.800 and it is truly priceless. 00:53:53.200 --> 00:53:56.600 People say: "But, what a horror! How can you work in this? 00:53:56.600 --> 00:53:59.600 How you can you be doing this for fifteen years and be happy, 00:53:59.600 --> 00:54:02.920 and still go happy to work? If this is horrible! 00:54:03.320 --> 00:54:06.200 All day with death, all day with severe illness, 00:54:06.480 --> 00:54:08.280 all day with suffering..." 00:54:09.120 --> 00:54:12.960 And here, I would like to say indeed, that when you switch the focus, 00:54:13.360 --> 00:54:15.720 when you learn how not to see the patient 00:54:15.720 --> 00:54:18.240 as a person you have to cure, 00:54:18.320 --> 00:54:20.600 but as a person you have to help, 00:54:20.680 --> 00:54:22.640 to accompany at the end of life, 00:54:23.000 --> 00:54:25.880 and you see the usefulness of you being there, 00:54:26.240 --> 00:54:28.920 being there as a doctor and as a person as well, 00:54:28.920 --> 00:54:31.600 accompanying them, that is so rewarding, 00:54:31.680 --> 00:54:36.680 that it really helps you in making your day-to-day much more rewarding 00:54:36.680 --> 00:54:38.920 than many other medical specialties. 00:54:39.480 --> 00:54:41.000 And that is what I´ve tried to do. 00:54:41.080 --> 00:54:44.840 To live my life as best as possible, to have a family. 00:54:45.000 --> 00:54:49.840 To have a family that loves me and which I love. 00:54:50.600 --> 00:54:54.840 And I am more that satisfied in life with that. 00:54:56.480 --> 00:54:58.400 Satisfied, very satisfied. 00:54:59.160 --> 00:55:02.320 So to all of you who are in my circumstances, 00:55:02.360 --> 00:55:04.040 I give you a hug from here 00:55:04.560 --> 00:55:07.000 and I hope to receive yours too. 00:55:09.280 --> 00:55:11.560 What I mainly take with me are the smiles. 00:55:11.920 --> 00:55:15.400 Amid the sadness, amid the sorrow 00:55:15.600 --> 00:55:18.920 and amid the emotional pain, 00:55:19.040 --> 00:55:24.840 there is that point at which the connection appears and the smile appears. 00:55:25.520 --> 00:55:29.280 The serene smile of patients in many moments, 00:55:29.320 --> 00:55:30.840 even though it seems unbelievable. 00:55:30.920 --> 00:55:33.360 The most beautiful love declarations, 00:55:33.400 --> 00:55:39.360 I've seen them in couples who are bidding farewell, you know? 00:55:39.400 --> 00:55:45.880 Couples who are caring for each other in the last phase of illness.