Medicine and Meaning: Palliative Care Nurse Emma Perry (SF04)
August 11, 2021 | By Eve Tolpa
Emma Perry (SF04) says her job is “a hundred percent about meaning.” As the palliative care coordinator at North Austin Medical Center, she helps patients with serious diseases focus on quality of life for themselves and their family.
“I initially got into nursing because it’s such a flexible career,” says Perry, who received an accelerated bachelor’s degree at Johns Hopkins School for Nursing in 2008 before moving to Austin, Texas, where she started out as a floor nurse. She was drawn to the profession for its flexibility but “didn’t know what I wanted to do. I just knew I wanted to be of service. It wasn’t until I got into hospice that I found my passion.”
Perry continues, “One of the things I absolutely loved about hospice medicine is that it finally treated a human being like a human being in all his or her aspects; as an individual, as a family member, and in terms of their particular spiritual needs.”
Though hospice care is administered at the end of a patient’s life, it’s not about the absence of medical intervention. It’s about being selective about what to treat and how, always looking at the bigger picture.
Perry characterizes hospice as a holistic care plan with the goal of making sure “every single day is the best day possible,” whether that translates into a family trip, a meal out, or sitting on the porch managing symptoms.
She worked in hospice from 2011 until 2019, when she was named Austin’s Hospice Nurse of the Year by the Austin American-Statesman and hired by North Austin Medical Center to initiate its palliative care program.
“Palliative care is different than hospice care,” she explains. “It entails the hospice philosophy but is pre-hospice. For example, if you had stage 4 cancer, you could do palliative care alongside chemotherapy and radiation.”
Then, when the treatment course is finished—either because there are no remaining medical alternatives or because the patient has decided they’ve had enough—“the palliative caterpillar becomes the hospice butterfly.”
Up until about 20 years ago, there was no real distinction made between hospice and palliative care, but since 2016, there’s been a growing movement toward offering the two approaches separately. Ideally, says Perry, both hospice and palliative care are “all about choice,” noting that she uses the skill set she learned at St. John’s more than anything else in her job training.
“I couldn’t be a good nurse with knowing the top five risk factors for diabetes, but what I really do is listen to people and advocate for them,” she says. “Good palliative care and good medicine and a good St. John’s seminar—all of it begins with a good question.”
Patients don’t always understand their diagnoses, so she listens carefully to discern what they know and what they don’t, making herself available to address any questions that might come up—including the pros and cons of various medical options.
“In a way I’m sort of a translator,” she says. “I’m also an unpacker of meaning for them.”
Perry has never shied away from complex lines of inquiry. She comes from a family of academics who “all thought St. John’s was amazing,” and her favorite college experiences were in the conversations that happened after seminar, when “everyone starts applying the discussion to themselves.”
“At Hopkins I really saw what sickness and death were,” she says. “What does it mean to be alive? Where is the line? Medicine can heal you and keep you alive, but at what cost? We live in a culture where we are often not comfortable having these discussions. These are complicated questions.”
In maintaining her peace of mind while serving as a sounding board for her patients, Perry finds it crucial to “get my ego out of the way. In my experience, if I attach my ego to some sort of outcome, I’m usually pretty miserable.”
At the end of each working day, she focuses on what she did to help, asking herself if everyone got what they needed—which might not be the same thing as what they wanted. “I go home every day and I know that I eliminated suffering,” she says. “Also electronic dance music is a wonderful palate cleanser, I’m not going to lie.”
What matters most to Perry is the search for meaning and how that pursuit in itself brings richness to life. “Everybody asks why I’m so happy all the time,” she says. “It’s because I’m front-row center in exploring meaning.”