A friend approached me today. His mom is ebbing away with one of the most primal challenges — losing her ability to breathe. A tumor grows around her vocal cords, constricting her ability to eat, or swallow her saliva, or breathe – while her mind works and shuts down internally into depression and despair.
‘’La médecine c’est guérir parfois, soulager souvent, consoler toujours’
This medieval French admonition to doctors is to ‘Cure occasionally, relieve often, comfort always’
Much of my experience with patients is one where they are more terrified of what doctors will do to them in pursuit of an often elusive cure. We have invented many novel methods of torture in the pursuit of life – and apply them indiscriminately in response to fears, anxiety, guilt and shame; both ours and the families’.
Over some time, we uncovered that his mom doesn’t want treatments. She wants to feel more comfortable. Lessening the tidal wave of fear of choking was the only comfort that made sense to offer.
I tinkered around with some solutions — cool humidified mist, thickened fluids, a touch of benzodiazepines to allay anxiety. We also talked about music, prayer, family, and food for taste or comfort rather than nourishment.
Where is our calling and ability to minister to those dying from our incurable maladies?
Palliative and supportive care medicine is just now reaching some recognition in most of the world. The Indian Supreme Court ruled recently that a person’s right to dignity and privacy included a natural death in a course of their choosing.
As the technology to cure improves, so must our resolve to releave and comfort those beyond our means.
I am eager to expand Navya’s palliative recommendations, especially in settings where we die suffering without any help or comfort. The full spectrum of care must include the ability to recognize a patient’s dignity and preferences, and to comfort – always.
-Dr. Naresh Ramarajan
Online Expert Opinion: navyanetwork.com/tmh
Tata Trusts: tatatrusts.org
Tata Memorial Center: tmc.gov.in