I’m actually not sure whether I am delighted or full-blown terrified. This morning I had a meeting discussing fascinating things like balance sheets, income statements, budgets and age analysis (can you hear the sarcasm?). In the meeting is a young man I’ve known since he was 18 months old. He is now in his late twenties, much taller than me, has more degrees than a thermostat and is beautifully ripped on top of it. I complain about some really strange staff incident and he suggests we replace all our HR with artificial intelligence. Would that not make life easier? We talk about how wonderfully OpenAI can write just about anything and decide to see what would happen if we asked ChatGPT to write us a poem on end-of-life care. Within seconds it writes the most moving poem which would give Dylan Thomas’ “Do not go gentle into that good night” a run for its money. (Where was this when I was struggling through essays on the Groot Trek?)
It is now a few hours later and I need to sit down and write my blog… I wonder what OpenAl would write? So, I cheekily ask it to write a blog on itself, and oh my word! I have no words. It wrote such a fabulous blog in mere seconds that I’m afraid I feel quite inadequate right now.
I do not begin to understand how it works, but what did pique my interest was that it says in the requested essay: “OpenAI chat represents a major step forward in the development of AI communication technology. As the model continues to be refined and improved, we can expect even more advanced and intuitive interactions with machines.”
How can a machine have intuition? Can we actually now get a robot to feel? If you are a regular reader of this blog you know that we do a lot of “winging it”. We learn as we go, we make spectacular mistakes and we are proudly anti-establishment, refusing to let a corrupt system dictate to us how we need to care for our guests. I love the fact that we adapt completely to the needs of each patient for whom we care, rather than forcing them to adapt to our schedule and our rules. We look after guests instinctively, learning their physical and emotional needs and then planning our care around that. Is AI going to be so advanced that it will now almost have a gut-feel?
Last week was an exhaustingly busy and stressful week, and I think my life would have been much easier if I had some kind of AI-robot writing verbal warnings, taking stock of our amenities, and the lives of my fellow road users would most certainly have improved if I had a self-driving car, but despite our lives being made so much better by technology, there are some things that we will just never ever be able to replace.
Last week we had a beautiful and dare I say it, noble death. It was particularly hard for me personally as there were moments during the gentleman’s last days that reminded me so much of my own dad’s passing. We do not have a standard plan or procedure when we serve an end-of-life patient. Our focus is very much on both patient and loved ones. Each case is as different as the next. In this case, the patient had many grandchildren that played endless hide-and-seek games around the lodge and were familiar with our surroundings. They saw their frail granddad and desperately sad granny and mom, dad, uncles and aunts cry and laugh and mourn. While he was with us at the lodge, our cats and the pool became familiar to them. These five grandkids were tenderly involved in his dying in a strangely informal way. When the pastor arrived to pray for him, the kids sat in. We carried an extra bed into the room so they could hang out with him, showing him pictures and nibbling on their peanut brittle. While the grandad was mostly slipping in and out of consciousness the kids told me stories about him, proudly expressing what a great baker he was and telling me about the chocolate muffins they got for breakfast on each birthday.
When he died mid-morning on Thursday, he was in the arms of his wife and daughter. His daughter asked us to prepare his body. Suzanne and I did it. We tucked him up, in a now familiar bed, put a rose on his chest, dimmed the lights, put on lovely music and then his grandkids arrived to say goodbye to his now completely lifeless body. No one was freaked out. He was just their “grampa” who looked very much like the guy they saw the day before, Except now, he looked more peaceful. They were allowed to go in and out of the room as many times as they needed. They had hot chocolate and toasted cheese sandwiches. Death was not gross or scary or traumatic. Their last memories of their grandad were beautiful, and because they were allowed these real, authentic memories, I think it will stop their impressionable minds making up scary memories mixed in with Zombie movies and the odd vampire climbing out of a casket. I’m not a psychologist, but I am sure this normality around his death will help them with their closure.
This setting, and this type of goodbye will definitely not work for everyone, and this is the first time we have ever had children as young as these see a dead body. But it worked for this family, and we knew it would because we knew them and understood their needs.
We have a patient with a relatively uncomplicated palliative care programme, but she recently got pneumonia and it is easy to follow the standard, tested and proven regime to treat this type of infection. However, her children know her, we know her, and despite the usual regime of 5ml of morphine every four hours, we know that once she is feeling too medicated, she does not move. We also know moving helps those exhausted inflamed lungs and her emotional state. Together with the children’s input, doctor’s advice and our instinct, we adapted how we treat her and after four frightfully unstable days I am delighted, that without any AI she is sitting up in her lazy boy this morning having rusks and coffee and proudly sporting a temperature which is so vanilla and normal we can even call it boring.
We have a 40-odd year old man with pancreatic cancer. He is Jewish (Will an AI robot remember to say Shabat Shallom on Fridays? Now that I think about it, the robot probably would? It would also be able to quote from the Torah). I wonder if a humanoid robot would patiently sit with a patient and spoon ice chips into his mouth because he is nauseous and can’t bear to look at food. Yes, it probably would. The AI would probably also tell better jokes, but the staff, patients and I laugh often and whole heartedly anyway, with our complete lack of artificial intelligence, or any intelligence at all?
I’m grateful this is not an “either or” situation. We have amazing AI available at our fingertips and we also have our guts, our instincts, our souls and our inclinations. Best of both worlds I think. Now. If they could just get AI to tell me where I forgot my reading glasses…