I dreaded death; I had never seen anyone dying. CANCER was a frightening thought and that’s when I got a chance to do a block placement at Regional Cancer Centre, Thiruvananthapuram. At RCC body parts and cancers related to them are divided from A- H so conveniently that the clerks and peons would casually ask a patient“oh is it a B case then its neck, throat, mouth related cancer”.I was in awe of the peons in my initial days there for they knew more than me.Sometimes they would even give verdicts to poor patients and their relatives waiting in OP, “chances are less, do you have a secondary growth, and oh is it hereditary??” By the time the patient reached the doctor’s desk he would be dead psychologically.
I got an opportunity to do my field work as a medical social worker at this hospital. Since I was a student and the hospital authorities felt I need exposure in all departments I was sent to every department from administration to OP , wards and even to help desk. Flocking people kept reminding me of the fact that there were more patients than I believed from ads, suffering from cancer. To give me hands on experience I was asked to sit in each clinic and department each day, though I reported to palliative care daily. OP would be full on Monday mornings with people coming for regular check ups.
I was amazed at how business minded the whole medical industry was. For instance a patient who came for chemotherapy was advised based on his income. There are treatments of various cost if you choose R 1500 one you need to take one course in three days if its Rs 5000 one in 10 days and If Rs 10000 once a month, so their treatment depended on their money and if you had no money – I have seen some patient lie in the corridor while relatives ran around begging for free treatment. Medical representatives canvassed people mercilessly to buy their products that it made me sick.
Another sight was tourists cum agents who brought patients from Maldives.This was also a business there and poor people from Maldives were at the mercy of these agents who were their middlemen to communicate to the doctors.Yet they lay there on the corridors having travelled all these hours hoping for a miracle.
I lost heart not once but many times and I wonder where god was when these people suffered. But I also saw serene, calm faces amidst this swarm which is perhaps what motivated the staf there to remain humane.Once at OP when a girl in her early twenties came with her father. She had cancer in her uterus and doctor explained if she was operated further spreading of disease could be arrested. After the whole discussion her father looked at us with great hope and asked “but she will be able to have a baby in future wont she?” I was dumbstruck, we took it for granted that he understood what it meant to operate and remove uterus. The doctor turned to me and said, take him in and counsel, leaving me to an awful situation of how to break the news.
In the palliative ward things were different, people there were brought after every treatment had failed and things were worse, pain relief and preparation to death were two goals of the palliative ward. The nurses and doctors were serene. But what made it hard to work there was that “every patient knew he was going to die” and “no patient wanted to die”.
I got acquainted with terms like death counseling and pain counseling at this place.
Sometimes listening to patients is therapeutic. They perhaps repeat the same stories that their family members get fed up with, so when we smile and listen to them their victories, grievances, anger , hopelessness , there is a relief most of them say they experience even when pain kills them. Sometimes wounds oozing and foul smell upsets the family members to sit with them. I have seen wives crying for husbands who deserted them, parents longing to see their children who don’t have time for them and grandparents wanting to play with grand children and some times all these roles gets transferred to students like us.
Each day when a patient died I have seen the fear on the faces of other patients, left behind counting their days, fearing dying, wanting to live despite the pain .Those were moments all my theories in counseling could not help me counsel anyone. Those were also days that brought me close to death, if you have sat with someone seeing them die and tried to ease their last minutes to make them feel peace you might understand what I am trying to say. When someone scared to die holds your hands and says now I am ready, and passes away, what could you say? He was brave; he had resolved the biggest crisis? He has won? I don’t know , I just know , with all the degrees I amassed , I would not be able to be that strong and death is the ultimate truth no matter how much I dread it.