Yesterday was my day to volunteer at TMH, at the Palliative care department. As usual, it was a fairly busy, heavy and hectic day. So many patients, so many people to break the news to, the bad news, the "I'm sorry but the curative treatment has ended" news, the news that now we have reached the 'end-of-life' care.....heartbreaking news.
The usual flow of patients and relatives coming in to the department have been struggling with the disease for a number of years and have the satisfaction of knowing that they did all they could to fight to live.They have been expecting the news that ultimately the cancer has won. They are tired of the constant fear, the endless bouts with the 'Emperor of all Diseases', the treatments that are as difficult as the disease, the nausea, the falling hair,the blackening skin, the RT feeding tubes, the oozing wounds and of course the worst of them all, the debilitating PAIN. When we break the news to such patients, you can see how tired they are. They have the blank eyes of trauma victims, the post war survivors. I am sure if we test them, we will find more than half of them are suffering from PTSD. These families have lost jobs, have their lives turned upside down, and are in financial debt to many.
As hard as it is to break the news to these long-term survivors, it is harder still to break the news to those who have just arrived to TMH. These people have come here with great expectations, hope and faith in the country's premier cancer treatment institution. These people go through the diagnosis stage and are then immediately sent to Pall care dept. No cures, no treatment for them. Either their cancer is too far advanced by the time they arrive or the kind that can't be treated. Such people when they come to our department aren't even sure what they are doing there. To hear their response to their prognosis, the oft repeated "are you sure? but we came here directly, how can it be that you can't do anything?"
Heartbreaking.
Yesterday was especially hard. We had patients from J&K, Bihar, M.P, U.P,interiors of Maharashtra, A.P. All first-timers to our department. All who had been recently diagnosed with cancer. All with different kinds of cancer. All with thin files indicating that they haven't been given extensive treatments for the simple reason that their cancer was incurable for a multitude of reasons, but 'incurable'. In hindi, we call it 'la-elaaj'. Breaking the news to these patients and watching the hope drain out of their eyes, brimming with tears, beseeching that surely there was something that could be done?
Yesterday, I was asked questions such as
"Do you believe that prayers can be heard? That faith in God will help my patient?"
"Can we try alternative treatments?"
"Will my son be able to survive the journey back home?"
This last question was asked by a 80 year old mother who herself did not look well. Her son, her only relative, unmarried, no siblings, no other family, no friends, who so far had been coming alone for treatments but was asked to call some relative so that they could be informed about the prognosis. So, he brought his mother.And so I broke the news to her. Her hands trembled. Her cataract cloudy eyes brimmed over. I'm sure I must have cried along with her. After talking to me for a while, she told me "bhaiya (she called her son that) ko mat batana," She didn't want to trouble him as he had fever.....And then, she thanked me for breaking the news to her!
In fact, yesterday I was thanked by all the relatives of patients for breaking the news to them. Thanked by the son who wanted us to help him keep his old mother comfortable till her time came. Thanked by the nineteen year old who wanted information about blood banks in his district so that when his mother needed it, he could rush her there. Thanked by the family of the woman who had a gaping festering wound. Thanked by the son who had flown his father straight out of his hometown to find a cure.
Yes, yesterday was especially hard for me but for those patients and relatives who were given this prognosis, it must have been excruciating!
The usual flow of patients and relatives coming in to the department have been struggling with the disease for a number of years and have the satisfaction of knowing that they did all they could to fight to live.They have been expecting the news that ultimately the cancer has won. They are tired of the constant fear, the endless bouts with the 'Emperor of all Diseases', the treatments that are as difficult as the disease, the nausea, the falling hair,the blackening skin, the RT feeding tubes, the oozing wounds and of course the worst of them all, the debilitating PAIN. When we break the news to such patients, you can see how tired they are. They have the blank eyes of trauma victims, the post war survivors. I am sure if we test them, we will find more than half of them are suffering from PTSD. These families have lost jobs, have their lives turned upside down, and are in financial debt to many.
As hard as it is to break the news to these long-term survivors, it is harder still to break the news to those who have just arrived to TMH. These people have come here with great expectations, hope and faith in the country's premier cancer treatment institution. These people go through the diagnosis stage and are then immediately sent to Pall care dept. No cures, no treatment for them. Either their cancer is too far advanced by the time they arrive or the kind that can't be treated. Such people when they come to our department aren't even sure what they are doing there. To hear their response to their prognosis, the oft repeated "are you sure? but we came here directly, how can it be that you can't do anything?"
Heartbreaking.
Yesterday was especially hard. We had patients from J&K, Bihar, M.P, U.P,interiors of Maharashtra, A.P. All first-timers to our department. All who had been recently diagnosed with cancer. All with different kinds of cancer. All with thin files indicating that they haven't been given extensive treatments for the simple reason that their cancer was incurable for a multitude of reasons, but 'incurable'. In hindi, we call it 'la-elaaj'. Breaking the news to these patients and watching the hope drain out of their eyes, brimming with tears, beseeching that surely there was something that could be done?
Yesterday, I was asked questions such as
"Do you believe that prayers can be heard? That faith in God will help my patient?"
"Can we try alternative treatments?"
"Will my son be able to survive the journey back home?"
This last question was asked by a 80 year old mother who herself did not look well. Her son, her only relative, unmarried, no siblings, no other family, no friends, who so far had been coming alone for treatments but was asked to call some relative so that they could be informed about the prognosis. So, he brought his mother.And so I broke the news to her. Her hands trembled. Her cataract cloudy eyes brimmed over. I'm sure I must have cried along with her. After talking to me for a while, she told me "bhaiya (she called her son that) ko mat batana," She didn't want to trouble him as he had fever.....And then, she thanked me for breaking the news to her!
In fact, yesterday I was thanked by all the relatives of patients for breaking the news to them. Thanked by the son who wanted us to help him keep his old mother comfortable till her time came. Thanked by the nineteen year old who wanted information about blood banks in his district so that when his mother needed it, he could rush her there. Thanked by the family of the woman who had a gaping festering wound. Thanked by the son who had flown his father straight out of his hometown to find a cure.
Yes, yesterday was especially hard for me but for those patients and relatives who were given this prognosis, it must have been excruciating!
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