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Learning When to Do and When to Be When Caring for Patients With Life-Limiting Illnesses

Learning When to Do and When to Be When Caring for Patients With Life-Limiting Illnesses

The sun poured onto my grandmother’s hospital bed.  She had managed to live on her own for 97 years.  But after a bad fall, she lay helpless, taking in the view of the Colorado mountains through the austere hospital window.


My grandma Hilda was new to hospital life, but she knew a thing or two about the bigger game she was playing.  She knew her time was running out.  She knew that there’s a time to fight and there’s a time to let go – to surrender into the primordial fact that what’s born must also die.


And so when I said, “hi grandma,” she looked at me with a radiant smile.  “God is love,” she said.  “I’m just so grateful to see you.  And I’m so grateful for my life, my family, and my house.”  In those final days, she talked a lot about that house.


Hilda’s 97 years of wisdom helped me learn an essential lesson in how to care for someone dealing with a life-limiting illness:  there’s a time to do and there’s a time to be.  And then there’s the wisdom to know which moments call for doing and which ones call for being.


Of course, the words “doing” and “being” are just words.  But they point to two very different experiences of life and two very different ways of caring for patients in a clinical setting.


These days, most of us are most familiar with doing.  To do, is to execute, plan, coordinate, and accomplish.  Many of us are professional doers.  We’re not paid to sit quietly while watching the sunset but to get stuff done.


Being, on the other hand, isn’t celebrated in a culture that values work, achievement, and success.  Being isn’t flashy or ultra-productive.  It’s the simple act of dropping into this moment.  It’s listening to the sound of the wind in the trees.  It’s the stillness of holding your aging family member’s hand when there’s nothing to do, nowhere to go.


In my book Start Here, we explore the importance of finding a balance between doing and being in everyday life.  And yet finding this balance is even more essential when caring for patients with life-limiting illnesses.



The Doing Trap


Since we’re all so good at doing, it’s easy to get trapped here.  And that’s often a good thing.  Doing, after all, is tremendously valuable when dealing with patients with complex medical needs.


Great caregivers are also great doers.  But here’s the trap:  doing can easily slip into overdoing.


Overdoing is what happens when we get stuck here.  It’s a state that can lead to risky treatment decisions, overmedicating, and pushing for treatment long after the time when it’s beneficial.


The greatest cost of overdoing, however, isn’t practical.  It’s emotional and spiritual.  Our tendency to stay focused on fighting the cancer, the dementia, or the heart disease can leave us blind to the exquisite experience of simply being with the person we’re caring for.


By overdoing, we end up living in a mental world consumed by thoughts of future treatments or worst case scenarios.  We miss the world that’s arising right now, in every moment – a world where there is another being with hopes, dreams, and a story right in front of us.  In short, we’re often so good at getting things done that we lose our access to compassion, love, and presence.


Finding the Balance


Overdoing isn’t helpful.  But the same goes for overbeing.  If we correct this common pattern by giving up on finding better treatments, medications, and healing strategies and simply surrendering to the moment, we’re also not fully caring.


We’re present and available.  But we’re failing to serve the best interests of our patients.


So the path forward is obvious.  It’s what Aristotle called “the mean,” what Buddha called “the middle way,” what the Christian Theologian Reinhold Niebuhr saw as a kind of “pessimistic optimism.”


The great spiritual and philosophical traditions all say the same thing:  to act with virtue is to learn how to discern too much from not enough.


When it comes to caregiving in a clinical setting, this insight can be a guiding principle.  Our goal is to do everything we can to help the patient.   And yet our goal is also to be open and available.


Here are a few tips to consider as you begin exploring finding the balance between being and doing:


  1. There Is No Formula – The practice of medicine tends to celebrate precision. There’s a right dosage, a right treatment, and data that drives every decision.  But there’s no formula for striking this balance between being and doing.  In fact, the ideal balance point is likely different for each person.   So, as you explore this idea, find the balance that works best for you.
  2. Take MicroMoments of Space – When you’re feeling stressed or tired, take a brief moment for a 4×4 breath to slow down and think through what to do next. To do this, all you have to do is breathe in for 4 counts and out for 4 counts, 4 times.
  3. Ask Yourself: “Is This a Time To Be or To Do?” – When facing difficult situations, use this question to guide your actions.   The majority of your day will likely be spent doing – helping patients with necessary logistical tasks.  But stay on the lookout for those moments when what your patients need most isn’t practical but is instead your full presence and compassion.


Finding this balance between being and doing isn’t just powerful at work.  It’s also a powerful practice to bring into the rest of your life.  When you’re at home, when you’re at a child’s sports game, when you’re at the store, explore what it looks like to weave micro-moments of being into the midst of all the things you have to do.




Nate Klemp, PhD, is the Co-Founder and Chief Innovation Officer at LIFE Cross Training (LIFE XT), a company devoted to giving professionals the tools to train resilience, wellbeing, and peak performance.  Along with Eric Langshur, he is the co-author of the New York Times Bestseller Start Here: Master the Lifelong Habit of Wellbeing.  Nate holds a B.A. and M.A. from Stanford University and a PhD from Princeton University.  @LIFE_XT or @DrNateKlemp