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The power of dying amidst love

Author: Cynthia Francis, Pre- Medical Student, Saint Louis University, United States
25 September 2014
  • Cynthia (centre) poses for the camera after a home visit
    Cynthia (centre) poses for the camera after a home visit

During her stint in Kerala, this pre-medical student from Saint Louis University, USA, saw the power of dying in the comfort of home with loving family members, in the frail patients succumbing to cancer.

Monsoon season is upon Kozhikode and the sporadic showers of rainfall are unpredictable. The air is so humid, I feel like I am taking gulps of water with each breath of air.

As my lungs slowly adjust to the climate, I carefully watch the students, faculty, volunteers and medical professionals of the Institute of Palliative Medicine (IPM) purposefully go about their daily tasks. Everyone is busy, but they will always stop to say hello. These individuals immediately gained my respect and admiration for their service to the Kozhikode community and their constant smiling faces.

Being a pre-medical student is an uphill battle that I believe you have to be slightly crazy to attempt to overcome. It’s very easy to get weighed down by the constant threat of entrance exams, class grades, observation, service hours and the endless years of education ahead. Admittedly, I had just finished my first year and I could already feel the increasing pressures begin to drown me. Overwhelmed by all of my own stresses, I began to lose sight of what a medical career really meant to me.Travelling to Kozhikode for two weeks to observe at IPM turned out to be the solution to my problem.

Rather than sitting in a library and memorizing the various functions of the digestive system, I was watching nurses, doctors, and volunteers actually treat patents. It was refreshing to see, first-hand, the effects of chronic illness and to gain unique insight into the purpose of palliative care as opposed to just reading about it in a textbook.

At IPM, I briefly forgot about my own problems and received a necessary reality check into the daily struggles of individuals from various backgrounds. For any student considering observation at IPM, I would absolutely recommend going on homecare visits. I still have vivid memories of the various homes we visited.

In the frail, elderly patients succumbing to certain types of cancer, I saw the power of dying in the comfort of home with loving family members. In contrast, most adults in the U.S. would prefer to stick their parents in depressing nursing or retirement homes rather than personally attend to them.

I also met a surprising number of paraplegics. These men were former workers who fell from coconut trees and, as a result, they were bedridden. However, I noticed that they made the best of their situation.

For example, I met one patient who now paints vivid images of nature and Christian themes. While he was receiving a urinary catheter change, I was admiringly gazing upon his many works that filled the walls of his home. I must admit, it is truly remarkable to see how well these patients cope with their circumstances. Luckily, most of them have supportive families and the caretakers of IPM to help them.

When dealing with chronic illness, it’s easy to lapse into the negative mentality of “What’s the point?” Why bother with treatments and receive care and attention when you are going to die anyway? It seems harsh to put it so bluntly, but surely these thoughts must trouble any member of a palliative care community?

One elderly man we saw on a home care visit remarked, “Difficult to live. Difficult to die.” I don’t think I could have put it in simpler terms. There will always be struggle and hardship to overcome throughout life. Medical school, getting a job, raising children, giving back to the community, discerning between faith and religion are not the only struggles. There will always be further obstacles to overcome. I suppose, attitude is what makes the difference.

The elderly man knew he was dying, but he wasn’t sitting inside, wallowing in self-pity. He was animatedly chatting with us about his study of Hindu mythology and astrology (both subjects that I knew very little about, but I still listened intently). This man had already made peace with his fate, and as he sat calmly on the porch with us, he seemed to possess an aura of calm understanding and strength that I can only hope to achieve at some point in my life.

For those students from other countries who are interested in observing at IPM, I can promise a humbling experience that you will never forget and others will never believe. If you choose to join IPM for a short period of time, I have some tips to offer.

  1. Stay at the guesthouse and make friends with others joining palliative medicine. The transition into a new environment would be easier when you can share new experiences with your colleagues.
  2. Go fundraising if you truly want to understand the various types of services provided by IPM and the funding it requires to provide them.
  3. Bring a notebook and jot down everything. Also bring a torch along because I hear that there are snakes at night, but I have never run into one.
  4. Don’t be wary of the food. Some of the best meals I had were at the random, roadside eateries that served huge mounds of rice on banana leaves.
  5. If the family offers you tea during a home visit, graciously accept. It would be disrespectful to refuse.
  6. Listen to each patient and caregiver. Absorb their words like a sponge. Take in every experience, relish every bite, and enjoy every moment because it will go by too fast.

When I return to life as a pre-medical student, I will remember my time at IPM and understand that it will always be “difficult to live, difficult to die” because each day is precious and we have so little time.

Thank you IPM and Dr Lulu Mathews for giving this student true insight into the power of a strong, supportive community and a unique medical experience. When I return in the future, hopefully, my medical education will have expanded. But, I cannot promise any improvement in my ability to speak Malayalam.

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