My final question to David was whether there was a patient journey in particular which has stayed with him. He was happy to share with me a story that he keeps very close to him: “Whilst working on a cancer ward there was a patient there who had a very advanced cancer and was incredibly symptomatic with it. She recognised she was at the end but because of how advanced her symptoms were she couldn’t go home. And, she was having a certain type of management that meant she couldn’t go to any hospice, so she was essentially stuck. She was young, not much younger than my own mother which was perhaps why I drew some sort of connection, and she had younger children. After she was told that there was no more chemo or surgery to be had and that it was just symptom control and palliative care, her immediate response was not sadness or grief but rather, she said she had tickets to a show coming up and she had planned to go with her family and that she wanted to go. It was in two weeks and that was all she wanted to do - she just wanted to be able to go to this show. I looked at this really unwell and frail lady and would worry that she wouldn’t even make it to the toilet, let alone leave the hospital to go to a show - I couldn’t see it happening. But, the palliative care team worked around the clock and threw every possible solution at it. The hospital arranged for a charity ambulance to take her, one of the ward nurses volunteered to go with her in case something went wrong and even the venue arranged for her to have private VIP booth for her and her family. From utter hopelessness and what seemed like such unrealistic expectations, over the two weeks, bearing in mind she got sicker and sicker, she went on that day, to that performance and she sat there with her family. She died in the hospital a few days later but I will never forget that case . Mostly because it taught me that it’s never hopeless. If you’ve got hope and drive and the team are there, you can make it happen because patients are always willing. She hadn’t given up. She’s one of the cases I will always hold onto."
Hope. Strength. Willingness. Drive. Control. These were recurrent words from my discussion with David. Whilst the palliative care speciality is associated so heavily with death, disease and mortality, through speaking to David I have learnt that all the sentiments and attitudes needed to flourish in life, are equally necessary, if not more essential, in the process of dying. Whilst other medical professions may view death as a failure, palliative care doctors understand that death is part of living, necessary to life - far from a failure. More so, palliative care doctors and nurses obtain the ability to transform death into something peaceful, individualised, and patient-driven and do so in a culturally and spiritually sensitive way. They play the advocate and the realist, they burst bubbles and spread hope. They operate at the crux - the intersection between life and death. While “angel” or “paladin” may be an unfitting label, they certainly do an incredible job and their work is highly valuable and meaningful.
In addition to enlightening and educating me on the many different aspects to palliative care, my discussion with David has completely changed my view of dying.
Like most people, death is scary to me. However, while talking about death remains a taboo and anxiety-inducing subject, I have realised that discussing death, its inevitability and its unpredictability, is important, comforting and healthy. Through my reading and interviewing I have come to realise that our bodies are in constant shift, constant change, continuously breaking and repairing. One day, repairment will become harder or impossible and things will go fatally wrong. Perhaps this is something we should expect - not block from our minds with high doses of over-optimism. Perhaps acknowledging this truth early in one’s life will ensure that life is lived to the fullest and allows for trivial anxieties to be rationalised and energy spent in the most valuable areas. Or perhaps, that only comes with hindsight, much like the advice share with David from his patients.
I have come to realise that whatever way my journey ends, whether that’s instantly like my father, or perhaps a long journey of successes and failures as experienced by David's patients, both can come with peace and painlessness. My biggest takeaway from my discussion with David is that despite all the unknown, unpredictability and uncertainty that comes with death and disease, above all, there is hope. If you have hope, there is hope. And if you don’t have hope, there are people who can reinstate this hope. One of which, is David.
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