Medicine Beyond Pills: A dose of humanity

Medicine Beyond Pills: A dose of humanity

– Ms Sneha P, Vallikkunnu, Kerala

Until two years ago, my understanding of palliative care was limited to a brief notation in my nursing studies, and as a topic for a potential essay question. Occasionally, I’d see the palliative care vehicle of our panchayat passing by while I was on vacation in my hometown. That was the extent of my knowledge with regard to palliative care.

After completing my studies, I joined a short-term training program in palliative care at the Institute of Palliative Medicine (IPM), Kozhikode, Kerala. Little did I know that this place would soon become the one place which I would never want to leave. My perspective about life began to change too from the moment I stepped into IPM. In a nutshell, IPM taught me that ‘humanity can be medicine’.

During my time at IPM I was gently taught that death, just like birth, is an essential part of life; A harsh reality, yet a simple and profound truth.

An individual’s health encompasses a holistic state of one’s physical, psychological, and social well-being. It is therefore crucial to prioritize all these aspects equally.

I recall a patient named Krishnan (name changed), who suffered from unbearable pain. Despite being on various pain medications, his pain persisted. It was then that hospital transferred him to the palliative care unit at IPM.  When Krishnan arrived, he was in tears due to his pain. Our first task was to therefore administer pain relief medication and calm him down before initiating any form of conversation.

Once he was settled, I accompanied the nurse who went to talk to Krishnan. Initially, he showed no interest to talk; but when we asked about his family, especially about his daughter, he became very enthusiastic. At this point in the conversation, I wondered why my colleague was asking Krishnan such questions when he had primarily come here to seek relief from his excruciating pain.

Over time, it dawned on me that Krishnan’s actual pain was not merely physical, but was more psychological. He knew that his condition was terminal and desperately wanted to see his daughter get married before he passed away. His daughter however, was reluctant to marry, given her father’s condition. This emotional turmoil manifested as physical pain for Krishnan. After having a heart-to-heart conversation with his daughter, Krishnan’s pain, which was seemingly incurable with medications, now began to subside gradually.

My experiences within the first few days of training at IPM were incredibly valuable and the lessons learnt then continue to resonate within me till date. While at IPM, I also felt that my understanding of nursing care was quite insignificant when compared to the profound lessons I learnt during this training period.

Another experience which left an indelible mark on me was that of 12-year-old Nihah (name changed), who was diagnosed with cancer. Nihas’s parents had unfortunately lost their younger son to cancer earlier. The hospital corridors were a familiar part of their life, for several years now. Nihah was diagnosed with cancer shortly after losing her younger brother to the very same disease! She had witnessed her beloved little brother’s suffering throughout his illness.

During Nihah’s journey, her parents were withdrawn and struggled to interact with anyone, including Nihah. The family meeting sessions helped comfort them and they began opening up and confronting their emotions.

It is during one such session when we learnt that the Nihah’s parents had faced tremendous opposition from their respective families when they got married. Both parents strongly believed that their childrens’ suffering was because of the curses from each of their families. Through continuous conversations, our team helped Nihah’s parents understand reality. Gradually, they began to interact with others. As Nihah took her last breath in her parents’ loving embrace, her father wept, saying, “I wish I was able to have brought my younger son here before he died. He could have then closed his eyes in peace, and surrounded by all of us.”

Such experiences have taught me invaluable lessons about the intricacies of human emotions and the importance of addressing a patient’s psychological and social well-being while also caring for one’s physical health.

The satisfaction I find now in palliative care is beyond expression! A single smile given by someone in pain, due to my efforts and care, is the greatest reward for me. I feel that being able to be that catalyst which brings a smile on someone’s face is an absolute privilege. For truth be told, humanity itself is the greatest healing balm.