The Privilege of Medical Social Work

by Kristy Brosz, BSc, BSW, MSW, RSW

     It inevitably stops social conversations. “I’m a medical social worker. I’m a counselor for individuals and families facing life-limiting and life-threatening illness.”

     The sad looks arrive. Eyebrows are raised. Pity faces stare back at me. Then some variation of the same question comes out in hesitant tones: “Isn’t it sad and difficult to work with death every day?”

     I want to answer the question honestly, but it’s not that simple. Instead, my mind flashes to some of the patients and families I’ve met along my social work journey.

  • An energetic 3-year-old is bouncing down the hallway to the playroom with her shiny bald head and Barney shirt. Little does she realize that her spirit, courage, determination, and sheer ability to fight for life have inspired a whole community to action. Her love of life has inspired an alliance of mothers whose children are also battling cancer. They are raising money by shaving their heads and donating it back to charities for the purpose of helping other mothers in the same situation.
  • The sweetest, most courageous 8-year-old I have ever met. She’s on a bed surrounded by everything in her favorite color -- pink! After three relapses with cancer, she now sits in a hospice bed and requests my presence. With her bright smile, she asks me to come close and whispers such a profoundly innocent question to me:  “Have I fought hard enough so Mommy, Daddy, and my sister will always know how much I love them?” I whisper back the only response I can think of, the one that comes from the heart: “Yes, my dear. More than you will ever know.” 
  • A grandfather who had the courage to complete a dignity therapy legacy document. Together, we shared the document with his granddaughter, a single mom struggling to make ends meet with her three children. She enacted the life wisdom and invitation offered in the precious writing shared by her grandfather—taking the leap, going back to school. With proud, happy, and delighted tears, he brought in her acceptance letter to share with me and to state that his life’s work was now complete.
  • A couple I have followed for some time who recently received difficult news. This week, they are each working on writing a good-bye letter to each other after 53 years of marriage together. They will offer me the honor of allowing a window into their lives by reading both letters out loud when we meet again. 
  • A patient who has arrived very early for Support Group who is sitting in the waiting room. After two years of planning, setbacks, creativity, never ending determination, and sheer force of will, he has done the life-time equivalent of climbing Mount Everest. He’s very eager to share with a group of patients who understand that, although he didn’t climb a mountain, what he did do was equally as remarkable—maybe even more so.
  • The Group Room filled with advanced cancer patients on the last day of a retreat. On the first day, the room felt cold, the air empty, hollow, filled with awkward and frightened silences. In just a few short days of leaning into life and death, in ways only those with a shared understanding can, the room feels warm and close. The silences are filled with a loving presence that transcends both words and life. A shared understanding among the patients forms bonds that can never be broken and a support stronger than anything medicine has seen.

     As my mind floats away from these images, I hear the question again: “Isn’t it so sad and difficult to work with death every day?” I hold tightly to those images and so many more as I attempt to answer. Instead, what comes to mind are words of Dr. Rachel Remen:

“The capacity to bless life is in everybody. We bless the life around us far more often than we realize. These blessings strengthen the life within us and offer a refuge from an indifferent world.”

     These words ring true to explain how blessed I am to be a medical social worker and just how much this is a field about experiencing life rather than focusing on death and sadness. This focus on engaging with life has blessed me with many life lessons that I carry with me in this work and throughout my life.

     While life may not be fair, it certainly is beautiful—particularly when I stop to soak in each moment. It has taught me what a true privilege it is to walk beside someone else who is suffering.  To witness grace, courage, optimism, determination, and creativity is incredibly sustaining for my soul. 

     This work has also revealed to me the secret powers contained within HOPE: it is fluid and ever-present. It exists in unexpected places. It can sustain even the weariest of hearts. It does its best work when vulnerability is allowed to flourish, and it truly is at its strongest when it’s given the power to exist in community.

     This work also provides me with a great reminder to pause before I judge another, as each one of us has our own story. To ensure I honor these stories, I must mindfully employ compassion even when I don’t fully know what another’s story holds.

     Finally, and perhaps the greatest blessing from this work, is the knowledge that fear is not the strongest force that can exist. Much can defeat it:  hope, compassion, faith, gratitude, perseverance, openness, communication, relationships, love, determination, courage, curiosity, and simply choosing to exist in this moment and the next moment.  Each one of these will always defeat fear—hands down!

     Again, I think back to the question about the difficulty in working as a medical social worker, and my answer becomes clear.

     “No. Not difficult and sad at all. In fact, just the opposite. It’s actually about celebrating life. I could not ask for a greater blessing for my life’s work. I experience the privilege of feeling overwhelming gratitude and witnessing resilience on a daily basis. It’s teaching me to live fully. What more could one ask in a career?” 

Kristy Brosz, BSc, BSW, MSW, RSW,  has worked with a variety of both pediatric and adult patients facing chronic and life-threatening illness. She currently works as a counselor for patients and their families in heart failure.