Open Letter Response

pallimed.org-An open letter to the spouses of palliative care professionals

Author: Emily Riegel, MD

When: December 31, 2014

1. The large topic or issue addressed in this open letter is palliative care, and more specifically, the experience of being a palliative care professional while also managing a relationship with a spouse.
2. The specific situation addressed within this open letter is mainly the author’s response to her spouse’s question, “How are you? How was your day?” She lists the possible answers she might give to this question on any given day, and the insufficiency of each one in helping her spouse to understand more than a mere glimpse of her experience. The lack of depth (and to quote the author, “honesty”) in her answer of “fine” or “it was a crazy day” leads her to write this open letter, in order to shed some light on the reality of what she faces from day to day.
3. The exigence of the author, or the motivation, is her desire for honesty. The answers she gives to her spouse on a daily basis are not sufficient in explaining the intricacies, the delightedness, and the sadness that regularly accompany her work. It was also December 31 when she posted this letter, the end of another year, and this motivates Riegel to be completely honest before starting 2015 with her spouse.
4. The persona of the author is the voice the author has chosen for this particular open letter. The persona she takes largely appeals to the pathos of the audience, as she describes her personal experiences working as a palliative care physician. She describes being yelled at and blamed for things outside of her control, and needing time to process or understand certain experiences for herself before she can bring her spouse into the picture. The author humbles herself throughout the process, and therefore also takes on an apologetic persona. Additionally, Riegel takes on a persona of gratitude, for as she nears the end of the open letter, she thanks her spouse for all the details of his/her reactions, including patience, empathy, and compassion.
5. The purpose of the letter is to shed some light on the emotional toll that working as a palliative care professional can have one someone, and how that might affect their personal relationships as well. Riegel is normalizing the experience for other healthcare professionals, especially those that work with people as they near the end of their lives.
6. Some specific points that the author presents are 1) The mundane monotony of life can and most likely will have an effect on most couples 2) There is a difficulty in trying to explain the roller coaster of emotions she experiences in her profession each day 3) Retelling stories that have a personal and impactful significance are nearly impossible to describe adequately 4) Despite actions sometimes to the contrary, the author will always hold a love and appreciation for her spouse.
7. The intended audience of this open letter is both her spouse and other palliative care physicians who can relate to the emotions she expresses.