May 14, 2022 | Pallium India ( copied with permission .)
Author: Dr Anjali Sreekumar, a Junior Palliative Care Physician at Pallium India, and, a devoted grand daughter
I am not one of those who are gifted with good communication skills. I could never convince anybody about anything! But things changed rewardingly once I transformed from a regular physician to a palliative care doctor.
My palliative care journey metamorphosised me to a new person and a better doctor; I am not the person I used to be; I also became a better wife, daughter and sister. I changed for the better in all of my other roles as well.
I lost both my paternal grandparents within a gap of one year. My grandfather, my inspiration in life, left us first.
My grandfather was a paraplegic patient, who was bedridden for almost 1.5 years. He had severe delirium; which a few of my family members sadly misinterpreted as him being actually possessed.
At the time of his passing, my parents, my uncle, and my aunt were all stuck overseas due to the Covid 19 imposed travel restrictions. My father was emotionally broken as he was unable to travel and see his father for one last time. For him, returning home meant he had to resign his job. This trauma resulted in him having to undergo several counselling sessions for acute depression.
It was heart breaking that none of my grandfather’s three children could visit him during those 1.5 years, which would have been their last visit.
I was the grandchild who was left to look after and care for him. I had just completed my MBBS and had returned home as a young doctor, with the intention of beginning to prepare for my post graduation exams. As my grandfather got sick, I didn’t know what to do with him! I reached a point when I had to choose between my career and my family.
After a lot of contemplation, I took the necessary step of returning home.
The journey thereafter was challenging. My grandfather was delirious on most days. Being a very self respecting person, he got very conscious and embarrassed for the times when he was naked and needed me to clean him up. As his delirium progressed, his only words were the names of his children.
Over time he developed bedsores. I had multiple consultations with a few top neurologists. They hardly spoke to me for five minutes. That is when I realised that, for them, he was just another paraplegic patient.
His quality of life continued to deteriorate as he endured severe pain, bedsores, and a ryles tube feed. He was not himself and finally passed away without his last wish being fulfilled; to meet his children one last time. I did my best in whatever way I could.
My grandfather passed away before I joined Pallium India. I was then unaware of a speciality called ‘Palliative Care’. I could therefore not use the knowledge I have now, to help relive his suffering. Six months into my new job, I realised that the most common cause of delirium was constipation. I wish I was aware and had the knowledge of palliative care when he was alive, so that I could bring in some positive changes during the last few days of his life. I terribly regret this till date and wish I had a chance to reverse things.
The second story I would like to share is, from after I joined Pallium India.
My paternal grandmother was suffering from Urosepsis and was intubated. Her cheeks bled due to BiPAP. This time however, things were different.
This time, I convinced my father to arrange for his younger brother and sister to come home and meet their mother. My next task was to make my father consent for the removal of my grandmother’s invasive measures. Understandably, he was hesitant to do so.
I then told him, “Please go near my granny and listen to what she wants to tell you.. and while you are there, just watch her for five minutes.”
He then went into the ICU to see her. When he came out, he shared that my granny had said, “Son, I want to see my children. I feel suffocated here. They are killing me. Please, let’s go home.”
I then asked him, “Do you want her last days to be like this?”
He simply said “No” and that he didn’t want to see her this way.
We removed her BiPAP and took her home and she died peacefully the next day.
I was content that I convinced my father to listen to his mother, which also made him realise what she felt and wanted.
I am glad that we had made it possible for her to see all her children, and that we could bring her back to her favourite place; to her own room and her own bed, which she had shared with grandpa for 45 beautiful years.
I am grateful to all my teachers and my mentors in palliative care, who have helped me reach where I am today. Through my experiences in the field of palliative care, I have learnt the value of being a doctor and to serve the poor and the needy. I have learnt to bring humanity into healthcare, which most professionals have unfortunately lost today.
While, many people envision doctors to be living gods, I believe that we doctors, should understand and respect our patients’ sentiments, their hopes and protect the trust that comes along with it. We must strive to atleast bring a smile on the person’s face who is sitting across us. Remember every patient is someone’s father, mother, sister, brother, etc. While meeting them in our consulting rooms, we must just ask ourselves, “If this person is a beloved of mine, how would I look after them?”. It is then that you find your answer.
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