Photo by Eric Keith / St. Joseph News-Press

Dr. Robert McMillen evaluates a patient at the Living Community while making his rounds.

Purchase this photo

Dorothy Blakesley doesn’t look like she’s dying.

The resident of St. Joseph’s Living Community relaxes in a recliner with her feet propped up for the doctor to see. Their swelling is down, and a stethoscope to her heart indicates the same thing: Ms. Blakesley is better.

Much better than when she was admitted to Hands of Hope Hospice — maybe too much better to be a hospice patient much longer.

“I think you’ve bounced back,” Dr. James McMillen, her physician and the hospice’s medical director, says.

“Well, you made me,” Ms. Blakesley replies. “You helped me an awful lot.”

It’s not the course anticipated for patients who enter end-of-life hospice care, which generally is designated only for people given less than six months to live. But it’s not too unusual, either, for Dr. McMillen’s patients.

“He’s taken really good care of her,” Lisa Simanowitz, a friend of Ms. Blakesley, says. “Anytime she needs anything, he makes sure she gets it. I think part of why she’s gotten well is because she’s had so much confidence in him.”

Success stories like this, even for people who have deteriorated to a near-death condition, fulfill the hope Dr. McMillen had when he left his private practice of 27 years to become Hands of Hope’s medical director four years ago. The former geriatrics and internal medicine physician saw a need for better end-of-life care in an industry where, he says, people all too often were dying alone and in pain.

“We can’t put our heads in the sand around these issues,” he says. “One of our most important responsibilities as healers is to offer comfort at the end of life, both to patients and their families.”

After his stop to see Ms. Blakesley, Dr. McMillen moves on to Living Community’s other hospice residents.

This is what he does on Fridays. During the week — amidst his responsibilities as medical director of several Heartland Health programs, including home health, palliative care, the community health plan and health information services — he makes house calls to patients who aren’t well enough to leave their homes. And he makes sure all his patients know he’s just a phone call away 24 hours a day, seven days a week.

Many of those he now cares for through hospice are people he once treated in his practice, including a man living his final minutes during Dr. McMillen’s rounds on a recent Friday.

“I took care of this gentleman, his wife and their son,” he says. “That facilitates my ability to do this job, because I already have a relationship with these people. And it’s really fulfilling for me to be able to reconnect with patients I cared for for a long time.”

It’s fulfilling, too, for him to know that as his patient dies on this rainy April morning, he and his family aren’t alone.

Hospice teams include not only a physician, but also a pharmacist, a social worker, a chaplain, a registered dietician, registered nurses, trained volunteers, bereavement counselors and more, and several members of this man’s team are nearby when he dies.

Dr. McMillen’s commitment not only to his patients but also to these teams of people who care for them is one of the reasons Jim Pierce, Hands of Hope’s resource specialist, nominated him for the Dr. Robert J. Stuber Physician Recognition Award, which he received last month.

“We meet as a staff every Wednesday morning, and talking to him once, he told me those four hours are the most important, most sacred in his schedule,” Mr. Pierce says, “because it’s when he reviews with others how his patients are doing. That really is symbolic of how he approaches hospice: He understands it’s a team effort.”

Dr. McMillen acts as part of a team even while making his rounds, going from room to room with nurse Caty Harrison.

“She’s got a new hairdo,” he comments to Ms. Harrison upon seeing Ruth Cox, who he notes looks much better than when he last saw her.

“You’re really something,” he tells Ms. Cox. “You’re like a cat with nine lives.”

His next patient, Nell Morris, is doing much better, as well — but she seems less concerned with her own condition than with the fact that she gets a visit from Dr. McMillen.

“There you are,” she exclaims when he walks through the door. “My gosh, I’ve missed you. I’ve missed you so much.”

It’s appreciation like this Dr. McMillen counts as one of the greatest joys of his job, not only when it comes from patients who are doing well, but also when he and the rest of the hospice team receive it from the families of patients who have died.

In Ms. Morris’ case, though, it seems death won’t be coming anytime too soon.

“It’s highly conceivable we’ll have to take her out of hospice,” Dr. McMillen says. “And Ms. Cox — we thought she was going to die two to three months ago, but she’s a just rose now. It’s a testament to the great care they get here.”

Lifestyles reporter Erin Wisdom can be reached at ewisdom@npgco.com.