Journal of Palliative Medicine

Daisy is 68. In the past few years, she has experienced life with a neurological condition causing progressive functional decline, pain, visual impairment and other indignities. Surprisingly to me, she cut a rug into the wee hours at my sister’s wedding in Ireland recently. Other days, she sleeps a whole lot and needs much assistance with mobility and ADLs from her loving, dedicated spouse, Abe.

Her spirit remains strong, however.

Daisy is also my mother-in-law. We have a fun and open relationship, and she is very candid with me. Hence, she gave me permission to write this article.
She has many medical providers. Her PCP is kind and responsive. She has excellent system- and organ-specific specialists in her team. Yet, she hasn’t seen a geriatrician or a palliative care physician to date.

So here I am, a geriatrician and hospice physician-in-training primed for action. I’m thinking I’m in optimal position to help her and her spouse navigate the systems, adjust polypharmacy, provide emotional and educational support.

But it’s not that easy.

On the one hand, I want to respect her coterie of providers and their expertise.
On the other, I want to get more actively involved in her care. Be the “go-to guy”. Take a more holistic approach. Optimize her care now and into the future. Plan ahead. Have difficult conversations. Laugh. Cry. Hug.
All the while JUST being her son-in-law, married to her only daughter, and father of her youngest grandchildren. Friend.
Right now, I straddle both sides. Yet, I have doubts as to whether I am a strong enough advocate for her. She says she would love to have me as her doctor.

I know for sure that is not recommended.

So, after some thought and the therapeutic arc of writing, I come to a more comfortable conclusion.
It’s not an EITHER/OR dichotomy.
Rather the answer is to meld son- AND doctor-in-law. Loving. Caring. Listening. Learning. All the while.

Has anyone else had similar experiences? Advice?

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