Celebrating compassion: The IAPC’s celebration of National Doctors’ Day

To acknowledge the expertise and dedication of our doctors in providing compassionate care for palliative care patients and caregivers, on this Doctors’ Day, the IAPC had invited submissions for a special initiative, ‘Celebrating compassion: Share your Palliative Care journey with the IAPC’. The initiative invited doctors practicing palliative medicine to share their thoughts, reflections, and experiences which have brought them immense satisfaction during their journey in palliative care.

Through this initiative, we hope to inspire our colleagues from the palliative care community and also educate those from outside the field to encourage their greater involvement in palliative care.

Please scroll down to view the very impressive, and interesting insights shared by our persistent colleagues during their journey in palliative care.

Last but not the least, the IAPC once again acknowledges and appreciates all our pioneers and every other doctor practising palliative medicine in India. Palliative care / medicine in the country would not be what it is today, if not for the efforts of each of you! 

*Pleases note: Submissions are showcased as presented. No edits have been made.

Getting into AIIMS, New Delhi by a national competition for just 4 seats in General category in 1992 was a challenge by itself; I was fascinated by technology in medicine & Critical care medicine was my passion & I followed my passion with an unbridled zeal till about a decade when I began to understand the suffering associated with such technology driven life sustaining measures; people were now dying lonly, painful, expensive & undignified deaths in the alien atmosphere of ICUs. Technology was paradoxically prolonging death rather than preserving life! I understood that death is ‘physiology’ & not a failure of medical treatment.

That is when I found my love in Palliative Medicine. I trained under the tutelage of late Prof. Jaeck Luczack at Poznan, Poland, followed by a stint in Paediatric Palliative care at the Warsaw Hospice for children. As I was appreciating a painting made by a dying person in a church in Poland, the Bishop lovingly presented it to me; that day I had promised him that I shall put up this painting in my Hospice in India & today that painting proudly adorns the wall of my rural Hospice.

I began my practice of palliation in a virgin community in 2004, in a rural setting in the tribal state of Jharkhand, without any funding, pooling in my personal savings & working pro bono to establish the first rural Hospice in India. Working in resource-poor settings taught me to rely on resources that were locally available, accessible, affordable & acceptable to the community. We began training the village women to be Palliative and geriatric aides. I became the Secretary of IAPC & it became the first national body to have its Secretariat in a rural setting. I went ahead to integrate other streams of medicine in palliation & National Association of Palliative Care for AYUSH and Integrative Medicine was born. The first culturally appropriate death doula course in India, Farishtey was then created. My current passion is Quantum physics, dying & afterlife.

Dr. Abhijit Dam
Hon. Medical Director
Kosish
Rural Jharkhand

I started my career in medicine as a Dentist. I came to know about Palliative Care (PC) when my dearest uncle was diagnosed with Lung cancer. I saw him suffer in his last days but I felt helpless.

Later I joined NFPM course. Little did I know that this was to become a turning point in my career. Many PC centres that I visited and many people I met along the way shaped my future. During PC training I volunteered at a hospice Abhayam in Chennai where I witnessed the extent that palliative care could relieve the suffering of the patients.

Following this I got an opportunity to join Cancer Institute. I was a part of and witnessed the building of a MDT and vertical integration of PC in oncology. After several attempts, I got an opportunity to join MSc Palliative Medicine course at Cardiff University with a Commonwealth Scholarship. This will probably back my skills with a degree.

At this juncture I found myself in a position wherein I had to decide between pursuing a career in PC versus continuing my dental practice and volunteer PC. Despite a lot of resistance from my friends, family and well-meaning colleagues, I decided to quit my dental practice for good and pursue the practice of palliative medicine. Occasionally, I doubt where my future will lie and whether my choice of career in PC was a correct decision. There is uncertainty of the role of Dentists in PC. There are many among PC community who feel that the practice of PC must be restricted to the chosen few.

I feel that art of medicine can be acquired with right training and passion. India is a huge country where PC penetration is still poor and we need a motivated work force to take it to every nook and cranny of the country. To this end, we will need the support of many professionals who are trained and keen to work in PC.

My journey in PC, though not as arduous as some pioneers, reflects the challenges faced by many in this field. I hope for a unified and compassionate PC community that supports the needy.

Dr Daniel Raj Joseph Thangasamy
Palliative Care Physician
Cancer Institute (WIA)
Adyar, Chennai, Tamil Nadu

The sterile white of the hospital room wasn’t always my battlefield. Once, I dreamt of wielding scalpels, of the triumphant pronouncements of successful surgeries. But life, as it often does, had a different path for me. Cancer, the cruel architect of suffering, became my unwelcome teacher, and palliative care, my unexpected calling.

My journey began in oncology and haematology in 2016. During my oncology patient care journey, I witnessed the power of this often misunderstood field. It wasn’t about aggressive interventions, but about comfort, about making his remaining days filled with the things that mattered – the patient’s favourite music, the warmth of the sun on patient face, and the quiet companionship of loved ones.

Witnessing palliative care’s profound impact on our patients ignited a spark within me. I saw the fear in my patient’s eyes morph into a quiet acceptance, the relentless pain replaced by moments of stolen peace. It wasn’t a cure but a gift – the gift of making the most of the time the patient had left.

My path to palliative care wasn’t without its challenges. The initial frustration of not “fixing” the problem was a hurdle. But with each patient, I learned to appreciate the victories in the seemingly mundane. A good night’s sleep after relentless pain, a shared laugh amidst tears, the ability to hold a grandchild one last time – these became the triumphs I celebrated.

Palliative care is a constant dance between acceptance and hope. We don’t offer cures, but we offer comfort, a listening ear, and a hand to hold. We navigate the labyrinth of emotions – fear, anger, and a profound sense of loss. It’s a privilege to be a part of these intimate journeys and to witness the strength of the human spirit even in the face of insurmountable odds.

The journey is far from easy, but the rewards are immeasurable. The gratitude in a patient’s eyes, and the whispered “thank you” from a grieving family members

Dr Anup Yadav
CMO
Opsan – oncology and palliative services around Neighbourhood
Gurugram

My journey in palliative care began in Feb 2018 with a deep commitment to serving those in need, particularly in rural communities of Coimbatore where access to healthcare is limited. As a palliative care doctor, I dedicated myself to providing compassionate care to poor patients, ensuring they received the support and comfort they needed during challenging times for 5 years.

Recognizing the importance of raising awareness about palliative care, I embarked on an ambitious mission to educate both the public and healthcare professionals. Over the course of my early career, I conducted close to 100 awareness sessions on cancer, prevention and early diagnosis also, highlighting the significance of palliative care and its impact on patient quality of life.

My efforts and dedication led to a significant milestone in my career: the opportunity to start and head the palliative care department at PSG Hospitals in 2020 during COVID era. This role allowed me to implement comprehensive palliative care programs, fostering a culture of empathy and support within the hospital. Under my leadership, the department grew, reaching more patients and improving the overall standard of care. I served the institution for nearly 3 years looking after the patients and their families along with the bereavement support.

Currently, I am proud to head the palliative care department at KMCH Hospital. In this role, I continue to advocate for patient-centered care, focusing on alleviating suffering and enhancing the quality of life for patients and their families. My journey reflects a steadfast commitment to palliative care, driven by a desire to make a meaningful difference in the lives of those facing serious illness.

Dr Harsha Singh
Palliative Care consultant
KMCH Hospitals
Coimbatore

My journey with palliative care began around the end of 2019, when I was browsing through my Twitter account. A post from a doctor who worked at ICMR talked about a “19-week online foundation course in palliative medicine.” It caught my attention simply because the term “palliative medicine” was new to me. My curiosity led me to register for the course.

Dr. MR Rajagopal delivered the first session titled “Introduction to Palliative Care”. I still remember having tears when he said, “We as doctors use our brain (knowledge) and hands (skill) to treat a patient; Do we really use our hearts to show empathy and compassion?” Without quite realising it at the time, my goals and preferences shifted in that moment.

Coming from Tirunelveli district in the state of Tamil Nadu, I found it challenging to explain palliative care to my colleagues and why I was prescribing opioids for treating pain. During my early years, When I presented myself as a Palliative Care Physician, they inquire, “Are you a practising “Paleo Dietician?”. I was exhausted explaining others, yet never wanted to give up. My parents & my beloved husband provided unwavering support. My husband always said, “Do what your heart says”.

We know that “The universe falls in love with a stubborn heart,” and I finally joined Pallium India in 2021 as a Palliative Care Physician. Moving to another state without knowing the language, having no one nearby, and being alone during the peak of COVID were really difficult, but Pallium India was like a second home. The patients whom I saw every day made me realise the importance of love and compassion in healthcare. Though it has been a difficult path, I can now confidently say that I am a member of this fantastic speciality and I am fortunate to be here. I aspired to become an obstetrician initially as I thought that bringing a new life would bring joy, but now I realise that accompanying someone in suffering and holding their hand when they are about to leave this world is an unmatched privilege.

Dr Hashmath Farhaana.S.
Associate – Programmes,
Dept of Education and Skill Building,
Pallium India Trust.

Realising the huge need of Paediatric Palliative Care (PPC) for non-cancer conditions, a project was initiated by the Department of Palliative Medicine, Tata Memorial Centre, Mumbai and Cipla Foundation (CF). The1st two centres were started at Chhatrapati Shivaji Maharaj Hospital, Kalwa and B. Y. L. Nair Hospital, Mumbai for PPC in 2019 and 2021 respectively. We initiated 3rd centre focussed on Neonatal Palliative Care at KEM Hospital, Mumbai in 2022. Keeping in mind the Palliative Care needs for Thalassemia, we started the 4th centre at MCGM PHO BMT CTC, Borivali. Trained multidisciplinary team comprises of a Doctor, Psychologist, Nurse and Social worker.

We have provided Palliative Care to almost 3492 families. More than 78% of the children have neurological conditions and rest 22% consists of children with Thalassemia, Juvenile Diabetes, SMA and Genetic conditions.

Having initiated this journey for non-oncological conditions, we are facing few challenges. The chronic conditions need prolonged care. Paediatricians tend to refer patients towards end of life. In situation where multiple children have same genetic conditions in a family, psychosocial burden increases in manifold. Our project is trying to fill the gaps. Good Symptom management, Physiotherapy, Counselling, skill development activities and Support group meetings are conducted regularly. We provide medicines, wheelchairs, ration.

We have seen that the quality of life with respect to emotional functioning has improved from 28% to 60 % and social functioning improved from 43% to 70%. The caregivers have expressed gratitude towards the program. The heartening thing is that non-Palliative Care doctors at the respective hospitals have realised the importance of Palliative Care units. We are happy to inform that the project at Kalwa has been taken over by Thane Municipal Corporation as per our intended objective.

No journey is complete without challenges but we are undaunted in our path of enhancing PPC.

Dr Jayita Deodhar & Dr Pradnya Talawadekar
Project coordinator
s
Tata Memorial Centre
Mumbai

It is a great pleasure to get this opportunity to share my journey in Palliative Care. Thanks to IAPC, for this enlightening initiative.

My journey began in 2018, when our Nursing Superintend, Ms Usha Sharma introduced me to Palliative Care. I took interest on the subject as during that time, my younger son had a relapse of the dreaded disease, CANCER, after five disease free years. Usha taught me the basics of PC, and guided me to take a training in it.

I underwent a 10 days Hands on Training in BBCI under the guidance of Dr Kabindra Bhagawati. During those 10 days, I got a clinical exposure of dealing with a terminally ill Cancer patient, to provide holistic and comfort care, pain relief with the use of narcotics, how to enhance the quality of life of a dying person and provide a dignified death.

My interest in PC gradually increased and I wanted to serve the society. That very year, Usha and myself, started the Pain and Palliative Care department in our esteemed hospital under the guidance of the Pioneer, Dr Dinesh Chandra Goswami and also Dr Kabindra Bhagawati and procured the licence for the use of Narcotic Drugs. I completed the IAPC Certificate course and also joined the Organizing Committee of IAPCON 2020 at Guwahati. Thus, I came to know Dr Arun Deka and team.

Our PC team at KGMT Multi-Speciality Hospital became stronger and we provided PC not only to terminally ill Cancer patients but also to the Non-Cancer and Geriatric patients.

In 2019, a mother who nurtured her handsome son till the age of 18 years, played the role of a Palliative Care Provider, to give comfort and solace to her dying son. Yes, my son became terminally ill and was admitted in our hospital. A mother doctor did her best, to nurse him, support him, comfort him and paved his way to heaven. “The Valiant Warrior”, a Memoir on my son, authored by me, has a chapter on Palliative Care for awareness.

Dr Monica Sharma
Medical Superintendent, Consultant Anaesthesia and Critical Care

KGMT Multi-Speciality Hospital

Gitanagar, Guwahati, Assam

Being a doctor I never thought ever about this prospective of Healthcare.

In palliative care we approach those patients who want to talk, who want somebody to listen to them, who want somebody to understand them and I am ready to talk, am ready to listen, am ready to understand.

As per me these are three most important words in palliative care Talking, Listening, Understanding.

Only after that you can start Management for a particular patient.

I always enjoy my part in palliative care because when a patient got satisfied only by our way to treat them by medication or by counselling.

On that time it’s a out of world feeling for me.

Many patient are attached with you by heart because as a caregivers of patients he watched all journey with us of a particular patient.so they know very well about our support towards their patients and families.

Palliative care doesn’t want a doctor or nurse or councillor. The need is only a good listener.

Doctors are already there in hospital where a patient got treated but we the palliative care physicians understand well and when we sit near to a patient he felt faimlier to us and become a friend of us.

I just completed a year in palliative care but it’s a golden period of my life.

Thank you.

Dr Pankaj Bhardwaj
Palliative care physician
CanSupport
Delhi

4 years back this day, if someone would have asked me, what is “Palliative Care”, I would have probably remained blank, or perhaps given a speculative answer. Cut to the present, “Palliative Care” is something that is deeply personal and is an indispensable part of my professional identity.

After completing MBBS, when I was to choose a specialisation for post-graduation, I almost knew what I didn’t want. Probably that made me take up this branch despite being discouraged by many people which mostly included fellow doctors.

I was alloted a seat in the most prestigious medical college of the country, All India Institute of Medical Sciences, New Delhi. Most doctors who knew me, were happy with the institute but said I “deserve” a “better” branch considering, that was my maiden attempt with preparation.

I still wonder why I wasn’t swayed by the discouragements.

I googled about the branch only to be disappointed, as the internet lacked enough information regarding the same. I had found out a little only about my HOD in the internet and was overwhelmed when I met her in the department for the first time. Since then I would say, Palliative care has changed my perspective towards life and I am a different person now.

4 years in this branch, and I feel I took the right decision.

The story I said was only to tell the readers, that most people and more importantly most doctors, don’t know about the branch (I wouldn’t have been discouraged by so many otherwise). Even if some of them know, they are likely misinformed with many myths about the branch, which are compounded by a lot of stigma.

A 2024 study by British Medical Journal found that 98% stage IV cancer patients don’t get Palliative Care in India. However, I still do believe drops make ocean, & together we can achieve the unachievable.

Each one of us can take the lead, train more people, to continue the chain of palliative care, so that it reaches the ailing patient at his home.

Dr Pratyasa Padhi
Senior Resident
IMS & SUM Hospital

Bhubaneswar

As an Oncologist, I enjoyed mostly being one of the primary physicians of decision-making process and was in the impression that I had delivered full justice to the patients. I have my fair share of experience in radiation, chemotherapy, and a bit of Palliative care. Prospects broaden with new technology, and enthusiastic for being the part of medical revolution. But as the life goes on identified lacunae in the process where I started tracking there is something missing in the delivery of patient care.

‘Extremes always exist in pairs but there’s only one middle path.’ Oncology –> Cure the disease [Disease directed]; whereas Palliative Care –> Comfort care [Illness directed]. As the saying goes, “No, treating illnesses is why we became patients is what makes most doctors miserable.” – Dr. Gregory House. Then I reminisced about my school days – ‘The Road Not Taken’ – Robert Frost. [Med. Onco Vs PC].

The journey is not smooth, the road less taken has glitches. Stepping down from primary physician to secondary physician needs lot of courage + passion for metamorphosis and faced numerous comments during the process.

My granny despite charming and adorable had a different fate of frailty and dementia, the journey was painful to us, but providing home care till death left us with NO regrets. I am able to intuit Palliative Care is just like CPR- Doctors of whatever specialization/ Graduates of any field/ human beings of any religion/ gender / caste should be cognizant of Palliative Care, and able to provide care at different levels within their horizons.

PALLIATIVE CARE ≈ CPR to patient wellbeing [Caregiver/Patient Rescue]

Palliative Care accommodated me to get connect to my inner core and aligns with my internal consistency.

Finally, I want to end my submission with a quote –

“The purpose of life is not to be happy. It is to be useful, to be honourable, to be compassionate, to have it make some difference that you have lived and lived well.” ― Ralph Waldo Emerson

Dr Ravi Kiran Pothamsetty
Consultant – Palliative Medicine, Dept. of Medical Oncology
Meenakshi Mission Hospital and Research Centre
Madurai, Tamil Nadu

PIERCING THE ARMOR

Rashida had sensed that things were not well with her first born, Salman. By the time the connection between his various symptoms -delayed milestones and hearing loss-aroused suspicion and he was diagnosed to have Hunter syndrome, she had delivered her second son. Tragically, he too was diagnosed with the same condition.

The mother single handedly looked after both children as the extended family, although willing, could not handle them. Their father had to work to support the family. Finances were tight.

She watched as her elder boy, Salman, slowly began to regress. Although there was relief that he could not hurt himself anymore through hyperactivity, there was also the sadness of seeing her son become bedbound.

I met her at her home shortly after Salman’s admission with aspiration pneumonia. While she recited the 14- year history of taking care of Salman, her eyes never teared up.

Rashida’s mission was to get the best possible care for her son. To that end, she would keep calling and asking for support, clearing doubts, wanting things done immediately. Many times, she came across as impatient, demanding, and unreasonable.

The day Salman died, after the religious function was over, Rashida called me. And for the first time, she cried. And she talked. About how her heart hurt, how her hopes were shattered, how she now knew what her younger son would go through. She talked about the humiliation of having to keep on asking-for support, for waiving hospital fees, for diapers, for protein formula. She said – “I know I must have been so irritating, but he is my son. I don’t care what people think of me. I would do anything for him.” She thanked the palliative care team and put the phone down, all her attention now on her younger son.

She taught me the impact of compassion.

The armour that she had put on to deal with all that she had to, could only be pierced by the compassion she received, allowing her to feel, to vent, and to be vulnerable.

Dr Sabitha Binu Ninan
Paediatric palliative care specialist
The Voluntary Health Services

Chennai

A Journey of Compassion: How Palliative Care Became My Calling

My journey into palliative care began with the loss of my grandmother to Alzheimer’s disease. Witnessing her suffering deeply affected me and inspired a desire to help others. My father, one of the initial volunteers of the first community-based palliative care service in our area, further influenced me. As a school student, I often accompanied the palliative care nurse on home visits, helping wherever I could. This experience planted the seed of my passion for palliative care. Although I initially became a doctor to fulfil my father’s dream, it has become my own mission, driven by three main feelings: fulfilment, empathy for patients, and a determination to improve my skills.

During my undergraduate years, I knew I wanted to focus on this field after graduation. Working as a medical officer in the ICU showed me the harsh realities of conventional medical care, where the focus is often only on treating the disease, not addressing the overall needs of patients and their families. I realised the need for better care and pursued additional training in palliative care, including courses from the Institute of Palliative Medicine (IPM) and the Indian Association of Palliative Care (IAPC). This realisation motivated me to leave the ICU and fully commit to palliative medicine. Moving to home-based palliative care allowed me to make a real difference in patients’ lives, providing comfort and dignity in their final days.

Empathy is at the heart of my approach to palliative care. My patients have taught me valuable lessons about life and happiness, even in the toughest situations. Now, as a junior resident, I’m dedicated to learning and growing every day, refining my abilities to make a meaningful difference in the lives of those who need it most. With gratitude and passion, I look forward to continuing this rewarding path.

Dr Shaheer Abdulla
Junior Resident in MD Palliative Medicine
JLN Medical College
Ajmer, Rajasthan

My journey from being a school teacher to becoming a doctor and working in palliative care has been a transformative and deeply fulfilling experience. It all began when I volunteered with a palliative care unit in a regional cancer hospital during my studies in social work in Hyderabad. Witnessing the profound impact of palliative care on patients and their families ignited a flame of compassion within me that I couldn’t ignore.

During my time as a volunteer, I had the privilege of walking alongside individuals facing life-limiting illnesses. I witnessed their physical pain, emotional struggles, and the profound challenges they faced on a daily basis. However, I also witnessed the incredible power of compassionate care, support, and the alleviation of suffering that palliative care provided.

These experiences motivated me to pursue my dream of becoming a doctor. I wanted to enhance my ability to make a difference in the lives of those going through difficult journeys, especially in the realm of end-of-life care. So, I embarked on the challenging path of medical school, driven by a deep desire to expand my knowledge and skills to better serve those in need.

After medical school, I made it a priority to seek additional training in palliative care. I recognized that, despite its immense value, palliative care often takes a back seat in medical education. I was determined to bridge this gap and equip myself with the expertise needed to provide comprehensive, compassionate care to patients and their families during their most vulnerable moments.

Now, as a doctor working in a hospice, I am humbled enough to be able to contribute to the field of palliative care. I am driven by the knowledge that I can make a positive impact on patients’ lives by alleviating their pain and providing them with comfort, dignity, and support. Each day, I strive to create a safe space for patients to ensure their voices are heard and respected.

Dr Vujjini Kamalakar Rao
Hospice physician
Sparsh hospice (a centre for palliative care)

Hyderabad

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