by Nadia Farheen 1) and Mostofa Kamal Chowdhury. In the palliative care ward, death is not an intruder. It walks among us like a familiar guest—sometimes silent, sometimes abrupt, but never unexpected.
Most of our patients arrive with advanced illnesses, most with incurable cancer. They come burdened with intractable pain, breathlessness, immobility, fungating wounds, and the dread of unstoppable bleeding. Beyond their physical agony lie hidden wounds—loneliness, despair, fear of leaving loved ones behind.
For us physicians, these sufferings are not distant observations; they are daily companions.
Over time, we have developed our resilience, the once-overwhelming presence of death, the weight of suffering, the endless difficult conversations, and the ceaseless tide of bereavement have shaped us to face the reality.
We have learned to speak of the unspeakable: the reality of incurability, the nearness of death. And yet, amid this practiced acceptance, certain patients pierce through our armor and leave an imprint that words can hardly capture.
One such story is of Mr. Z, a middle-aged man whose life was marked by two formidable illnesses—hemophilia A and buccal carcinoma with bony metastasis.
Hemophilia had shaped his life since childhood, but he had always found a way through. Factor VIII injections restored his strength whenever hemarthrosis crippled him. But as a silver lining, there was always a cure, a recovery, a return to normalcy.
But cancer was different. What began as a small lesion above his left mandible grew into a monstrous shadow, robbing him of hope. He knocked on every door—surgeons, oncologists, healers—but the verdict was unchanging. The cancer was incurable. From then on, his treatments were limited to pain relief, wound care, and occasional injections to keep bleeding in check.
He was admitted to the palliative care ward three times. From the beginning, he and his wife faced the truth with remarkable courage. They knew about the catastrophic risk—the possibility that the cancer might erode into the carotid artery, unleashing a torrent of bleeding. Yet, rather than succumbing to despair, they brought light wherever they went.
His wife, his tireless caregiver, became his only companion in defying despair. Together, they still sought joy in small things: taking long drives with the wind in their hair, sitting quietly in a cinema hall, or capturing photos of his changing face—not out of vanity, but as a testament to their journey together.
As the cancer was metastasizing rapidly, almost all of his left jaw was eroded, leaving a large blood clot,posing immense challenges during regular dressings. A bandage, like a thick noose around the neck, soaked in dried blood and permeated with an intolerable odor, became a mandatory body part of him. Remaining the only caregiver for a long tireless time, his wife also started falling sick.
One morning during ward rounds, we encountered a moment that left me marveled. Mr. Z, frail and barely able to sit up, reached into his medicine box. With trembling fingers, he pulled out tablets—not for himself, but for his wife. He placed them gently in her hands and whispered, “Please love, you must take some rest. I can look after myself.”
It was a scene at once surreal and profoundly human—the dying man caring for the one who had given him every ounce of her strength.
Two days later, on a Friday, the ‘angel of death’ finally came, and sat too close to his carotid artery! The catastrophic bleeding was swift and devastating. For a moment, the ward was gripped by terror. But we shielded what we could. We covered him with a dark towel, administered midazolam to ease his final moments, and stood by his wife as she clutched his fading hand.
With our own trembling hands, we tried to absorb the weight of the inevitable.
In palliative care, there are several times when we cannot halt suffering or stop death’s advance.
We might not offer a cure, but all we can do is remain present—offering compassion, dignity, and love until the last breath.
Mr. Z’s story reminds us why love remains the true Holy Grail. Even as death sits at the bedside, love has the power to soften its terror and give meaning to the final journey.
———————–
- Palliative Medicine Specialist, Dhaka, Bangladesh
- Associate Professor, Department of Palliative Medicine, Bangladesh Medical University, Dhaka, Bangladesh
Leave a Reply