Abstract
Arecently published article highlighted using “the bucket list” as a simple framework to engage patients about their health care decision making and its potential impact on the patient's life goals. 1 This week I was consulted to see a patient who declined stem cell transplantation for leukemia, despite reasonable odds of survival and against the wishes of both the team and her family. Tearfully, she relayed that she felt strongly she would not survive the transplant given her poor tolerance to chemotherapy. She looked at the picture on the wall of a pristine white beach with aqua water and sea oats blowing in the breeze and said, “I want to be there. I wrote my own bucket list and that is what I will fight for. I am not afraid to die.”
That evening I thought about my patient and scribbled my own bucket list for the first time in my palliative care career. I have always dreamed of sailing. Yesterday, I drove to a local lake and signed up for a sailing class. After swimming laps, saving a buoy, and up righting a tipped vessel, I successfully passed both a written and practical test. Elated and somewhat fearful, I dropped off my sailing guide and set sail alone. I noticed an osprey furiously pumping its wings to cross the lake. Suddenly, the bird caught a gust of wind and soared across the ominous sky filled with gray clouds. The glassiness of the water blurred as the wind rippled the surface. My sail suddenly caught the wind and pulled me soaring across the lake. I locked the sheet and yelled out loud, “I'm sailing!” I zigzagged, jibbing, and tacking across the lake, filled with gratitude for the experience. I am the bird, and I am indebted to my patients for helping me see life through a lens—not of dying, but of living life to the fullest.