Hospice care ‘part of the big picture’

One of the common misconceptions about hospice and end-of-life care, according to Dr. William Krall, is that it’s morbid, depressing and heartbreaking.

But for Dr. Krall, who has been part of Hospice of Hamilton since before it was Hospice of Hamilton, it’s just another aspect of medical care, part of “the big picture.”

“In medicine, we’re supposed to cure disease and ease suffering,” Krall said. “Hospice is all about relieving suffering. We don’t cure many diseases in hospice, but that’s not our goal.

“Our goal here is that when people have reached the point where they have a terminal illness and have decided that it’s futile to cure the disease and would rather focus on being comfortable in the time they have left.

“I don’t see that as being alien to the practice of medicine at all,” he said. “It’s kind of the natural evolution of what you expect.”

Still, hospice is a relatively new concept to medicine he said, although the idea of a terminal illness has been around for thousands of years.

“In the last century people have gotten into the mind set that if you just find the right pill, the right diagnosis, we can cure anything,” he said. “With that logic, we should be able to live forever.

“It never happens.”

Born at Ft. Hamilton Hospital in 1948, Krall grew up in a working class environment. His father, and even his mother for a time, worked for Champion Papers while he went to Fillmore Elementary, Wilson Junior High and Taft High School before going to Miami University. He got his medical degree from the Ohio State University in 1973, and in 1979 set up practice in Fairfield, mostly in general internal medicine, but also some pulmonary care.

About 20 years ago, he was asked to volunteer for Miami Valley Hospice, the first hospice care center in Hamilton, then helped open a small hospice program at Mercy Hospital before it moved out of town.

“They were taken over by Hospice of Cincinnati,” he said. “We opened up the first in-patient unit here at the old Mercy Hospital, then after they closed down we moved over to Sunrise, we had a wing over there for a number of years, then five years ago we opened up a facility here” in the former Pillsbury factory on Eaton Avenue.

He said that he sometimes shocks his patients when he tells them that everyone he cares for is going to die.

“But it’s true,” he said. “I’m going to die, you’re going to die, we’re all going to die. If we realize that or know that we have a limited time and the disease that we have is not something we’re going to cure, then I don’t want to waste my time on futile efforts. I’d rather spend my time doing something I like.”

Although the goal of immortality is futile, even the medical community falls into the trap, he said.

“When I was in training at the University of Cincinnati back in the 70s, I don’t think anybody was allowed to die in the hospital without going through CPR,” he said. “We just learned CPR and all those things we could use to keep people alive.”

Through much of the 20th century, in fact, more and more people started dying in hospitals.

“A hundred years ago, that wasn’t the case,” he said. “Most people died at home, surrounded by family and by loved ones.

More people are spending the last time of their life in hospice care or in palliative care than they were 20 years ago.

“Maybe we’re backing away from that now,” he said. “More people are spending the last time of their life in hospice care or in palliative care than they were 20 years ago. We’re getting back to, ‘Hey, it’s going to happen, there’s nothing I can do to stop it. Do I want to be in a sterile environment with strangers — who may be trying to take care of me but who are poking and prodding me at all hours of the night — or would I rather be with friends and family in a familiar environment.

“I agree with that very much.”

Krall concedes that it can be heart-breaking, especially when he’s caring for someone 35 or 40 years old with a family.

On the other hand, it can be rewarding to have a patient who’s 80 or 85 years old, they’ve got a chronic illness and know they’re going to die and accepted it.

“If they’ve reassured their family that it’s okay, my time has come, that’s a warm and satisfying feeling,” he said. “Certainly the family is going to be sad at the passing of a loved one, but they do it with dignity, surrounded by friends and family.”

After dealing with matters of life and death all day long, Dr. Krall likes to go out for more trivial pursuits. Literally.

He’s part of a trivia team that plays every Tuesday night at a pub in Glendale, and has become something of a resident trivia master himself.

Last August, Krall emceed a trivia night fundraiser at Ryan’s Tavern and raised about $1,600 for Hospice of Hamilton.

On March 21, he’ll be reprising the role.

Pre-registration cost before March 15 is $30 for an individual and $55 for a couple. Cost at the door is $35. Admission includes a buffet and non-alcoholic drinks. Cost for buffet only is $20.

There will be a raffle, silent auction, and split the pot. For more information or to register a team, call Debbie Hauenstein at 513-373-8223.