Trendwatcher: Modernizing Health Care – and Death Care

© RIA NovostiNatalia Antonova
Natalia Antonova  - Sputnik International
“Hello!” Medical personnel were greeting me in a cheerful, offhand manner as they went about their business among the pretty landscape paintings on the second floor of Moscow’s First Hospice (Perviy Moskovsky Hospice). My mind, summarily, was blown.

“Hello!” Medical personnel were greeting me in a cheerful, offhand manner as they went about their business among the pretty landscape paintings on the second floor of Moscow’s First Hospice (Perviy Moskovsky Hospice). My mind, summarily, was blown.

Most Muscovites I know expect hospices to be dreary places. “Poor you!” a fairly progressive-minded friend told me after he heard I took a trip over to the Perviy Moskovsky. “Were you terrified?”

When I tried explaining to him that not only it is a nice place – a bit like an old country estate with modern accents – but that it markedly differs from most state-run medical facilities by employing people who, for one thing, have manners, he refused to believe me at first.

And why should he? The idea that death should be horrifying, and that everyone who comes into regular contact with it should be at best hysterical and at worst profoundly callous, remains pretty popular throughout the world, not just in Russia.

After writing about the agonizing death of bard Ada Yakusheva, I wanted to come face-to-face with the people who are changing our expectations surrounding death. And Nyuta Federmesser, the daughter of the late founder of Perviy Moskovsky, Vera Millionshchikova, and the head of the Vera Fund, which specializes in aiding local hospices, is one of those people. Sitting in her mother’s office, surrounded by old photographs, I was reminded of the reason as to why I became a journalist in the first place.

I live in hope, you see. I don’t want to spend the rest of my life writing headlines about how Everything Everywhere Is Terrible – although they obviously still come with the territory. I also wish to observer character arcs – not just for individuals, but for societies. And the work of Federmesser and those like her is, to me, the clear beginning of one such character arc.

Sitting in Millionshchikova’s quiet office, Federmesser and I talked about how close the experiences of birth and death really are. Having been lucky enough to give birth to my son in one of the best hospitals in Moscow, and while financially broke, no less, I realized that Perviy Moskovsky Hospice is probably one of the best places here to die. And while we certainly expect and demand professionalism from OB/GYNs, it should be the same for the people who are seeing us off from life.

Now, you’re probably asking yourself why on earth it matters that the people who work in Perviy Moskovsky actually greet strangers – as opposed to, say, demanding, “What are you doing here?” – which would have been the standard response to me at your more typical medical establishment.

It matters a whole lot, actually. Working with dying patients and doing it well requires a certain kind of openness, as Federmesser reminded me. When it comes to death, ignorance is certainly not bliss – and the dying patient needs to be in contact with people who are willing to share information and look them in the eye while doing it. This will not necessarily make the process easier, but it does make it more dignified.

Federmesser told me that it always surprises her when people show up inquiring about transferring a dying relative to the hospice and proceed to ask the doctors to, “Just don’t say anything to my mother, please. We’re telling her she has a lung infection.” Meanwhile, “mom” has already been to all of the different major cancer clinics in town. Mom has had chemotherapy. Mom lost her hair. Mom has endured months of difficult treatment. Mom is not an idiot and deserves to be treated as such.

The truth is, you can have all of the money in the world, and all of the pain medication that’s available (and in Russia, bureaucratic matters can still make it difficult to obtain), but if you’re dealing with medical professionals who are terrified of bringing up death with a patient – the end will be that much harder.

The legacy of Soviet medicine was all about medical victories, you see. Dying patients were bad for statistics. Nobody wanted to deal with them – and few were encouraged to take a professional interest.

This approach certainly made sense in a country that made a dizzying leap into industrialization, and triumphantly shed the mysticism that traditionally surrounded both illness and death.  

But the Soviet Union itself has now died. And with Russia modernizing once again, a dying person should be given access to both support and knowledge just as simply as we can get access to Wi-Fi in the cavernous depths of the subway system.

The views expressed in this article are the author's and do not necessarily represent those of RIA Novosti.

Trendwatching in Russia is an extreme sport: if you’re not dodging champagne corks at weddings, you’re busy avoiding getting trampled by spike heels on public transportation. Thankfully, due to an amazing combination of masochism and bravado, I will do it for you while you read all about it from the safety of your living room.

Natalia Antonova is the deputy editor of The Moscow News. She also works as a playwright – her work has been featured at the Lyubimovka Festival in Moscow and Gogolfest in Kiev, Ukraine. She was borxn in Ukraine, but spent most of her life in the United States. She graduated from Duke University, where she majored in English and Slavic Literature. Before coming to Moscow, she worked in Dubai, UAE and Amman, Jordan. Her writing has been featured in The Guardian, Foreign Policy, Russia Profile, AlterNet, et al.

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