Palliative care: Power of companionship for the terminally ill
Mr Mehta (name changed) lived his life binging on wine, women and wealth. Being a rich businessman, he cared little about his folks, which constituted a pretty wife, a daughter and a son. At the age of 58, he was diagnosed with a terminal sarcoma, for which he was operated twice at the best hospitals in Mumbai. Yet the the cancer kept coming back, larger and more ferocious each time. It had maliciously spread into the lungs and infiltrated his pelvic bone, he was unable to excrete and urinate, leave alone eating normally. He landed up in my OPD teary-eyed with a servant woman half his age. All he wanted, was a painless death. He quipped , “ Life hurts a lot! I won’t be surprised if death takes me. I am ready to go! Allow me to experience normalcy till I am alive.”
I performed a palliative colostomy for stool and inserted a urinary pipe from the ventral part of the abdomen. When I visited him the next day, Mr Mehta was all smiles. He had passed satisfactory stool and the urine was effortless. He couldn’t thank me enough. I met his wife who made a courtesy visit. She looked concerned, but in peace with herself. Their son gave me a measured grin!
I visited him a week later at his home in Charni Road at his insistence. In the dead of night at 2 am, I travelled the length and breadth of Mumbai. ‘Bombay’ as I prefer to call it, has a different hue of black at that time of night, it is quieter, placid and more picturesque. I presumed this invite was the result of end-of-day’s work, and conjectured a red-carpet welcome at the Mehta residence and speculated floral ovation from his friends and family.
As I entered his colony, the excitement waned. There was an eerie silence in the building. There were no friends, no family. The same young servant woman I met in the OPD greeted me downstairs. ‘He has been impatiently waiting for you’ she whispered. My spinal circuits sent a shock-like shiver down my cord. The old man looked miserable again but this time the problems were different. He showed me the photo of his daughter. She lived in Australia. He had called her to see him one last time-she had flatly refused. His wife was living with their son and they too had spurned his invitation to be with him. Living with a servant girl, he had no one to talk to and called me simply for a shoulder to cry on.
For the first time in my life, I had the beautiful experience of sharing the life of a dying man. He spoke about his work, escapades, his now worthless fortune. But most conversations spun around his family. Even at 5 in the morning, sleep didn’t bother me. We shared hearty laughs, eye-moistening family dramas, and edgy stories about his youth. I wished the old man good luck and left satisfied early next morning, ignoring my driver’s grumpy looks.
The last time Mr M called me, was when he shifted to ‘Shanti Avedhana’ in Bandra. It’s a small palliative/end-of-life care home for dying cancer patients and treatment is free of cost. He was happy to be there pand have people around him who had been through similar experiences. The pain (mental & physical) dwindled and happiness quotient doubled. Currently, he is awaiting my visit and vice versa. As I write this story, I call him. His happiness in talking to me is palpable over phone and I promise to visit him in the next 2 days.
I realise, most terminally ill patients require neither surgery nor chemotherapy. They do not ask for wounds to heal, nor pains to dissolve. All they appeal for is to allay their fears, mollify their minds, and for the forgiveness of their sins.
It isn’t that difficult, is it?
Dr Donald Babu is a Surgical Oncologist and Robotic Surgeon practicing at MGM Hospital, Navi Mumbai. He is also an Associate Professor at the Oncology Department of the JJ group of Hospitals, Mumbai.
Originally published at Connected Health Quarterly.