Dr M R Rajgopal
Founder, Pain and Palliative Care Society, Kozhikode
I was trained as an anaesthesiologist in the early part of my career, when the responsibility of giving relief from pain was gradually coming into our field. In Calicut (now Kozhikode), where I first began working at a senior level, I was doing nerve blocks on various parts of the body.
However, an experience with one patient in the 1980s compelled me to take a fresh look at what I was doing. This was a 42-year old college professor, suffering from cancer, and he was referred to me for pain relief. I did for him what I had done for numerous others and his pain receded but a day later, he committed suicide! Everyone in my department was shocked because here was a case where our treatment was a success, and yet we lost the patient.
On enquiry, I was told that he had been given the impression that my treatment was intended to cure his cancer. Nobody had made it clear that it was for the limited purpose of relieving the severe pain that he was suffering from. When he realized that his cancer was essentially incurable, he gave up all hope of life itself.
It conveyed to me the invaluable lesson that every doctor must look at his patient as a whole person, and not just a collection of organ systems. It is a mistake that many doctors make even today – they treat the disease, and not the person suffering from a disease.
For me as an individual, it brought me face to face with my calling – to develop the (then) nascent field of palliative care. My colleagues and I work through an organization named Pain and Palliative Care Society, based in Kozhikode. Set up in 1993, it is able to reach out to patients wherever they are. Thus, we have managed to cater to over 3 million patients till now.
Our experience has lessons for doctors and healthcare professionals in other countries as well, because of which we have worked with the WHO Collaborating Centre of the Pain and Policy Studies Group (PPSG) from a very early stage. Here, the purpose was to bring about changes in the regulatory policy with regard to opioids and other pain-relief medicines. In a situation of terminal illness, we can take the risk of the patient developing an addiction, if it means improving the quality of life for the patient in the final stages. In such cases, the priority becomes different from the usual.
The huge tragedy of healthcare today is that, because it fails to view the patient as a whole, the doctors inflict suffering in the process of treating a disease!
— As told to Dr Sumit Ghoshal