Finding Comfort and Peace 3

Dr. Bob Uslander, Integrated MD Care

It is another sun-drenched Saturday morning in San Diego County and the streets are brimming with life. Cyclists, joggers and surfers crowd the sidewalks and soak up every minute of the new day.

To them, death is a distant, unwelcome foe, but to Dr. Bob Uslander, the idea of dying is like a reunion with an old friend. As a palliative care physician, Dr. Bob (as his patients know him) helps individuals and families find peace in the face of illness and aging.

Sitting on a blue sofa in his Del Mar office, Dr. Bob is completely at ease. His young golden retriever, Lily Joy, sits at his feet. Behind him, the tide slowly flows from the marsh back into the ocean. As he talks about his practice, there is an unmistakable enthusiasm and passion in his voice. “My practice is not focused just on the end of life because there is so much more,” he says with a smile.

To relieve his patients of their symptoms, Dr. Bob provides in-home, holistic care that often combines art, music, acupuncture and massage therapy as well as traditional medicine. Dr. Bob’s practice also seeks to support and guide family members confronting difficult end of life care decisions.

Each case is unique, but the ultimate goal is to deliver unreserved compassion and give each patient the ability to be fully present in the final moments of their life. Some of Dr. Bob’s patients experience an improvement in their overall condition after beginning treatment with him and his team. It is proof, he says, of the healing properties of touch and human connection. “Some of these patients are able to live a rich, full life, even in the face of an illness like cancer,” he says.

Dr. Bob works with many families in the La Jolla community, and considers all of them as his friends. Former patients range from Nobel Prize winners and professors to doctors and businessmen. Lasting connections are developed with each of the families he works with, and he admits that it can be difficult when a patient dies. Still, Dr. Bob chooses to find the beauty in moments he experiences with his patients. “There are joyful events in the midst of difficult circumstances that they cherish, and I do too.

Before working in palliative and end of life care, Dr. Bob was an emergency physician. Throughout much of his earlier practice, he would do everything in his power to bring people back from the edge of death, regardless of the outcome. He now understands that this approach can be short-sighted and insensitive to what many people would want.

The transition may seem unnatural – shifting from a career of saving lives at all costs to supporting those at the end of life. Through personal experiences, however, Dr. Bob discovered that dying could be a beautiful and dignifying process. He has provided in-home, end of life care for a close friend diagnosed with cancer, as well as for both of his parents. He believes he has found his calling.

Dr. Bob maintains that his work as a palliative care physician is just as meaningful and fills a void that has long been ignored by the traditional healthcare system. As a mentor, guide, sounding board and friend, Dr. Bob’s patients rely on him for support in life’s most challenging moments. Sometimes, it is as simple as providing information about the illness or aging process to patients so that they can understand what is to come. Other times, it involves helping a family get their loved one out of a hospital or nursing home and providing the care they need right at home.

“We are all going to die, we cannot change that, but we can help reduce the fear of what will happen before we die,” Dr. Bob says. “Once you can remove that fear, then people are open to experiencing the real power of a life ending. We remove barriers to being connected and sharing love.

The greatest downside to his model of care, Dr. Bob confesses, is that not everyone will be able to afford it, since his services are not paid for by insurance. To meet the needs of community members that may not be able to afford this model of care, Dr. Bob is helping to create a foundation so that other families may be able to experience the same level of support and access to the healing therapies that his own patients receive.

Providing compassionate care for patients nearing the end of life, freeing them from pain or suffering, and helping them be completely present in life’s final moments, is a gift. To give that gift, Dr. Bob says, is an honor.