Palliative Care - A Reflection

The past 3 weeks in palliative care has been an interesting experience. My original knowledge of palliative care was that it deals with end of life situations and involves lots of painkillers. Now I know that palliative care treats the patient and the family as a whole, physically, psychosocially and spiritually. Admissions for respite and symptom control play a big role in the whole picture as well. Painkillers, while an integral part of care, is by no means the only drug used.

It’s a very different world from all the other rotations I’ve been through so far. The aim is not to cure the patient but to ensure that s/he is as comfortable as possible during their remaining time alive. To that end a multidisciplinary team (and drugs of course) is essential and this is the first time I have noticed all the different teams functioning together as a unit. It is refreshing to see, after being bombarded so often that medicine is multidisciplinary, the different disciplines actually closely interacting instead of just leaving information for each other in the case notes.

After a while it really struck me how accurate it is to be empathic instead of sympathetic in this field. One simply cannot afford to be sympathetic and maintain his/her own sanity with all the grieving and, sometimes unchecked emotions that occur in this place. The fact that sometimes not saying anything and just listening is the best thing you can do for a patient or family member was reinforced as well.

The many quirks of the different staff members made me laugh on many an occasion. It never ceases to amaze me how sometimes, especially in this particular field, how a simple laugh can make you feel so much better. Everyone was friendly and accommodating, even if they were stressed from dealing with difficult patients, and made me feel a part of the unit.

I have had the opportunity to learn how to certify that a person is clinically dead: Check for pulse, heartbeat, respirations, breath sounds and look for dilated fixed pupils. Having never physically been in contact with a corpse before, I was surprised how cold the body was just hours after death and the how rigor feels like.

I've seen many cases of cancers, some kinder ones and some really aggressive ones. I've literally seen a walking corpse (omg how much more cachectic can someone get?), I've seen the terminal stage of a few patients (which tend to scare the heck out of their family members) and we had a patient with a really dysfunctional family.

Along the way I believe I have gained some knowledge on analgesics, sedatives and laxatives throughout my attachment as well. This will undoubtedly prove useful to me in the future.

It seems like 3 weeks is just about right to gain an idea of what palliative care is like as a profession. I am happy to have experienced something which I knew very little about just a month ago. It has helped broaden my knowledge and, I daresay, helped me grow a little as a human being.

Many thanks goes to Heath for helping me along the way, giving little tips on whatever and giving me work to do when I was bored :) Thanks also goes out to Rebecca for all her 'preaching' sessions (I love it how she ends all her teaching sessions with "OK, that's enough preaching for now.") which made me do homework and were of great help to me :)