Relationships and the importance of flexible hope: Interview with Karin Thron

The Narrative with Matt Lewis is a blog series that explores the importance of human connection, relationships, and hope, topics central to the mission of 3rd Conversation and important for all of us during this time of uncertainty. As the chief storyteller of 3rd Conversation, Matt is an expert on the use of narrative as a tool for connection, teamwork, and leadership development.

This month’s interview is with Karin Thron, MD, Hospice Medical Director for Ambercare Hospice and Family Medicine practitioner in Santa Fe, NM.


*Note: this interview was conducted in 2020


ML: From a global pandemic to social justice and policing, everything has been changing so fast. It has been a really overwhelming, busy year. How has your experience been?


Despite the chaos all around, I feel like my life and my work have been relatively steady. I am so grateful that is the case. I just push on; put my head down. I feel so grateful that every day I get up, go on, and that no one in my personal world is sick or dying. So, mostly I try to focus on gratitude.


ML: The ‘front lines of care’ are now so different. Have you been impacted from the shift to telemedicine or are your days still mostly in-person contact?


In a lot of ways, we have the privilege of still having one-on-one contact with patients. But patients who are in their homes have different comfort levels. We try to get creative to match their needs.


We have done visits through screen doors or ‘window visits,’ which have challenges, especially when you add in privacy concerns or connecting with individuals who may have vision or hearing loss.

Still, I’m very privileged that a lot of my work is still able to be conducted in person. I can still see the nurses, do co-visits with them, etc. From our perspective, telehealth visits have not been the most useful tool because many of our patients aren’t familiar with it and it’s an odd experience for hospice care. The in-person connection really matters.


ML: Listening to you describe in-person care reminds me that you are someone who is deeply compassionate– and I know this because I have had the privilege of shadowing you while you work. So, if it is a universal human truth that it’s hard for us to connect with realities that aren’t our personal experiences, and now more than ever we need to be doing just that, what is your trick for bridging that gap? What is your trick for compassion?


In a one-to-one or familial setting, it’s easier for me to understand the situation and respond to someone’s needs. I always remember the wisdom of: ‘there but for the grace of God, go I’– as in, whatever someone else is going through, that too could be me. So, with my patients, just the two of us, I find it easy to be empathetic and compassionate.


But to tap into the bigger collective experience of human pain and suffering over the last year with this global pandemic, for me, that can be overwhelming and difficult.

I find I have to step back. It’s similar to how I feel about the ocean. I love being at the shore, but when I’m out in the open sea… the enormity can be too much. I once had an experience where I was out in open water and the boat started floating away. The waves weren’t large, but the swell made it hard to see the other people with me. There was a moment where I felt totally alone in this vast expanse. I had to swim for the boat but had no clear sense of where it was. Momentary disorientation.


In the end, we were all fine; we all made it back to the boat. But that feeling of how overwhelming the possible outcomes were in that moment– that’s how I feel about the collective COVID experience.


There is an informative counter example from history: war. Because to see the visual helps us understand the impact– like we did with images from the Vietnam War or the Holocaust. But I haven’t had that same visual touchpoint with COVID. Partly, and mercifully, it’s that I haven’t been directly impacted, but it’s also because it’s happening inside the hospitals and people aren’t seeing it.


So, the idea of having to make decisions about who is going to get the oxygen or the ventilators– ethically, I understand it, but in reality, I can’t really grapple with what that feels like. It is just too big.


ML: The 3rd Conversation centers around the belief that the power source, the fuel for change, is relationships and human connection. You are relational on so many different fronts – what do you see as the role of human connection in these strained, isolated times?


I’m grateful that I’ve been able to maintain relationships, to still have human connection during this time. I am generally such a relational person that being in isolation would be a real challenge for me. So many people have chosen to be alone or live alone in this day and age, to have their own place, to be far from family– and this was the case even before COVID, a byproduct of modern life. When they come into the end of their life, it’s challenging to witness how that plays out. Some people are in fact comfortable dying alone, and others really want the relational piece to help them through that time.


There are also physical implications to feeling isolated and alone. It’s been disturbing to watch many of our patients in facilities decline much more quickly than anticipated.


Our guess is that it is related to loneliness and lack of engagement because their families were unable to visit or could only visit with restrictions that made connection difficult.

Many people have pulled their family members out of facilities because they don’t think it’s right to not have access to their family. It’s heartbreaking to watch people go through that; to think about someone dying alone. The human connection is so important– it literally impacts physical health.


ML: With everything that has been going on, where are the places and spaces giving you hope?


Hope is so important. And I truly believe, because I have seen it time and time again in my work, we can always continue to have hope and find hope, right up until the very end, as long as we can adapt what we are hoping for. For example: if a patient I am supporting hopes to live to be 100 so he or she can meet his or her great-great-grandchildren and then gets a terminal diagnosis, can that hope change to making it to a 75th birthday or seeing a grandchild graduate from high school?


There is a real power in our capacity to adapt our hope.

We find resilience when we open up our thinking to allow for different possibilities. And it is amazing how adaptable we are. It’s amazing how quickly people have been able to adapt to the new reality of wearing masks. It was a big change, and now we’re just doing it. Our capacity to do the adaptions that this year has required gives me hope. The conversations, the willingness to address the issues that have risen and think about ways to meet the challenge, that too gives me hope. The many ways that people have gotten creative with technology to meet their emotional and relational needs. I see many reasons for hope.