Dr Shashi Sharma
“If you cry because the Sun has gone out of your life, your tears will prevent you from seeing the Stars”.
– Rabindranath Tagore
We live in the unprecedented times. The COVID-19 Pandemic had taken so much from so many of us. The health care system is grappling with the massive changes brought about by the pandemic. Human vulnerability and mental health issues, grief, adjustment, bereavement, suicides and so on are becoming more common in the present times. We are constantly reminded of the suffering and death.
So, friends the ‘Pallative Care’ given to the cancer patients for relieving the pain—is really that Hidden Star.
World Health Organization (WHO) defines palliative care as “The active total care of patients whose disease is not responsive to curative treatment”. It supports variety of goals, including relief of suffering, control of symptoms, restoration of functional capacity and so on.
As doctors we see a lot of sufferings and death. We are trained to cure and save everyone but in reality we are able to save and cure only a small number. Thus, the focus needs to be shifted from Curing to Caring and Healing. From Treating Illness to Elevating Suffering—now the question arises How?
At this junction Palliative care seems to be most needed to address not only the Quality of Life but also the Quality of Dying. In cases where people die of severe pain-something had to be done for a peaceful painless death..
Now a day’s though lives are prolonged but the illnesses have turned chronic, there by compromising with the quality of life. Here The ‘Pallative Care’ comes to the rescue.
It is unique in providing total care to patient including :
* Physical
* Emotional
* Social
* Spiritual
This means that the approach should change from Patient to person with illness, along with the family. It aims at improving quality of life and also quality of dying for example: In advanced cancer cases which have been treated with Surgery, Chemotherapy, Radiation and even Immunotherapy or a combination of all these. Palliative Care now can be the anchor around all problems including Nausea, Vomiting, Mouth ulcers, Fungating wounds, Diarrohea, Constipation, Depression among many others. In such cases pain is the main curse along with many other problems when such patients are sent back home.. Palliative Model Does Not Equate Death With Defeat But Accepts Death As A Natural Close Of Life.
A good news for Jammuites in this sphere:
With the active initiative of Government Medical College staff a functional Palliative Unit has been established under the aegis of Health and Medical Education DepartmentIn which a team of three doctors and two nurses were trained by AIIMS ( New Delhi) to start the Palliative Care Centre in GMC Jammu
Team started with the regular OPD along with intergated approach with other medical specialties like Medicine, Surgery, Obs and gynae, Orthopedics, Radiotherapy etc. When ever needed the specialists refer the patients to Palliative Care Team for management of various problems faced by cancer and chronically ill patients like suffering from End stage heart disease, Chronic kidney disease, Dementia, Paralyzed bed ridden patients and so on, in which care is much needed.
Apart from this, thirty nurses of the associated hospital were trained under ELNEC- American Association of Colleges Of Nursing (End Of Life Nursing Education Consortium) in collaboration with the Palliative Care Team in a three day workshop, where they were trained to take care of the terminally sick patients.
Further the Palliative Care Team is motivating young doctors to undergo CCEPC (Certificate Course In Essential Of Palliative Care) Course conducted by AIIMS (New Delhi). One such course has recently been completed and examination was conducted in GMC Jammu in April 2022.
These trainings are necessary for our young doctors—Why ?
As we know 96% adult population and 99% child population suffer from Pain at one time or the other. Although India is largest producer of OPOIDS (like Morphine) which is basically a painkiller but unfortunately doctors were never trained to use it as a painkiller till recently.
Morphine being a ‘Wonder Drug’, it relives the most painful conditions. Myths associated with this drug are a big barrier in its use. The word morphine was a taboo, not only in general public as an addiction but even doctors were scared to use it. Doctors also linked morphine giving to dying patients. So, these trainings dispel the myths regarding morphine as a drug given only to dying patients.
With the efforts of Indian Association Of Palliative care (IAPC) Amendment in the NDPS Act of 1985 was done in 2014. Hence the use of Morphine was allowed as pain reliever much to the relief of doctors and cancer patients in particular. The tertiary care hospitals like GMC Jammu were registered as RMIs (Recognized medical Institute) which can Store and Dispense morphine without the need of any license.
Now morphine as pain reliever is now made available on doctors prescription in GMC Jammu —-Palliative Care Unit with safety guidelines.
It’s the time now for the public to approach when needed the Pallative Care OPD:
Room No- 7 (Medicine OPD daily)
Daily from 10 am to 4 pm (except Sunday).
‘Let me not pray to be sheltered from dangers, but to be fearless in facing them.
Let me not beg for the stilling of my pain, but for the heart to conquer it.’
— Rabindranath Tagore
(The author is Principal GMC Jammu)
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