General Medicine – my forte

Oncology – oh dear, the big C.

Palliative Care – “Pally C” referred to a colleague I worked with during my new graduate year in 2014.

“Palliative care is person and family-centred care provided for a person with an active, progressive, advanced disease, who has little or no prospect of cure and who is expected to die, and for whom the primary goal is to optimise the quality of life.”

I’ve talked frequently with the wonderful PALC specialist nurses on my wards (CNCs) about palliative care and the role they play in an individual’s experience. The first and foremost thing they feel is necessary to address: palliative care is not a death wish, it’s not always imminent. It’s more of – I guess, a way to plan for future events, precede future events, and ultimately, inform patients and families about choices, ways of living, ideas on how to get home for a terminal experience, humanity and care.

Sometimes we aren’t able to get our patients home and sometimes they don’t want to die at home. There is a lot of understandable anxiety surrounding death.

I had a patient ask me today what to expect… He didn’t elaborate on what he meant by “what should I expect?” I answered honestly, “you will probably lose interest in eating, you might feel increased pain but we have pain relief and other medicines ready for you. You might feel tired or agitated. We will make sure you are comfortable and maintain your dignity whilst we also care for your loved ones.” Shortly after this, he fell into a deep sleep. The doctors told me given his infective pericardial effusion and metastatic cancer diagnosis, that he’d probably pass tonight.

Whether he does or he does not pass tonight is irrelevant to us as healthcare providers. The goal is always the same. Treat people with dignity, acknowledge a life lived, acknowledge a person loved; take care of their loved ones even if to make a cup of tea; after all, it is as much a privilege of bringing life into the world as it is farewelling someone leaving the world.

Be kind, for everyone you know is fighting a hard battle.