From the doctor's perspective

My experience at Ganga Prem Hospice
(by Dr Rajiv Kumar Saxena)

I am a novice to the field of palliative care. My firsthand experience after four days of home care visits has been very touching and satisfying.

I was overwhelmed by the love and affection received from the patients and their relatives. In the era of ever growing queues at hospitals and long waiting periods at consultants' chambers, our home care visits were seen as a God sent gift. Except for a few, most of the patients were in great agony. Physical ailments (mainly pain) have taken a toll on their confidence and morale.

Dr Saxena examining a patient in her home

We were seen as someone with the Midas touch who could offer some miraculous cure. Primarily I tried to boost their morale and dispense medicines according to their complaints, but their needs go beyond alleviation of symptoms and reassurance. Some were unable to carry out further treatment because of financial constraints and the high cost of treatment involved. Even a minuscule percentage of financial aid can make a drastic improvement in the cancer patient's treatment by not just improving quality of life but by prolonging it also.

Patience is a primary trait which we have to develop. Listening, responding to concerns and providing relief from physical ailments, as well as dealing with social, psychological, cultural and spiritual needs of patients and their family members should be our primary objective. We can not change their destiny but our efforts can make an appreciable difference. Caring is as paramount as curing. Our patients need and deserve our empathy.

Ours is a small but significant step in cancer care. I hope that in time it will come to grow to much bigger heights. It will help us to achieve our goal of improving the quality of life of patients and their families.

Do we have control over dying?
(by Dr AK Dewan)

I have witnessed the death of people who have learnt to love fully. Such deaths are peaceful, pain free, a letting go; deaths in which no time is spent dying.

Many times, you might have observed elderly people having a premonition about their dying. They are at peace. They might announce their end a few hours before their actual demise. I vividly remember my grand father saying, Call my daughter in law and my grand children. I may not see the sunset.

Do we have some control over our own dying? You may not agree with me if I say 'yes' but there is often proof of this when people die in a hospital. The majority of patients die in the early hours of the morning when the lifesavers are resting and when family members have left or fallen asleep. Probably all these patients are constantly balancing the rewards of life versus the cost of living . We must realize that patients are not 'living or dying' but 'alive or dead'. If someone is called 'terminally ill,' he is often treated as dead. This is wrong. If one is alive, one can still laugh, live and love.

An elderly lady, Mrs. Kee (name changed) was receiving chemotherapy for her advanced breast cancer. Her husband met with an accident and was admitted in the ICU of a multi specialty hospital. He required ventilatory support at night. Relatives did not want to tell Mrs. Kee about the condition of her husband. The next day we came to know that both husband and wife had passed away. Mrs. Kee followed Mr. Kee after a gap of just 5 minutes. The cause of death in the case of Mrs. Kee could not be ascertained. This was probably a living death where feelings were unspoken, conflicts unresolved. Sometimes life goes on only for the sake of others.

Death can be natural and peaceful. A young patient of mine was loved and taken care of so well in his last days that he left a note at the time of his death saying, The last month of my life was the best period of my life. Thank you for the love showered on me. I am taking it with me. On the other hand, death can be artificially prolonged with needles, tubes and ventilators and become a life without dignity. This is not control at the time of death. Control at the time of dying is natural, peaceful and subconscious.


PATIENT'S STORIES
Cancer patients and their loved ones are invited to write to us about their views, thoughts and feelings. We will include as many letters, articles and stories as is possible in these web pages.

Please send your article to Nani Ma: nanima@gangapremhospice.org.