A Shift in Perspective: Understanding Pain in Palliative Care

Categories: Opinion and People & Places.


In the world of palliative care, pain is an unwelcome but an ever-present companion. It’s a silent scream, a relentless shadow that envelops the lives of those battling terminal illnesses. Within the delicate ecosystem of this field, the role of healthcare professionals goes far beyond administering medication and managing symptoms. It requires an understanding of the subjective nature of pain and, more importantly, the ability to truly listen and empathize with patients.

I vividly recall a recent posting at the Institute of Palliative Medicine (IPM) that was a turning point in my perspective of pain management. I encountered a patient, Mr. X, an old man who was battling advanced cancer. He had a ‘reputation’ among the staff for being ‘difficult’ and ‘demanding’ when it came to pain relief. During my first encounter with him, I was quick to cast judgment. I couldn’t help but think he was exaggerating his pain to secure more medication.

My initial skepticism was, in part, due to my inexperience and preconceived notions about pain in palliative care. I couldn’t fathom the depths of suffering Mr. X was enduring. Instead of listening to him, I made the grave mistake of assuming he was attempting to manipulate the system for his benefit.

It was during a routine visit that I witnessed the true extent of Mr. X’s agony. He described his pain not in medical jargon but in raw, unfiltered terms. He painted a picture of his suffering that was far more vivid than any clinical assessment could convey. He spoke of sleepless nights, the relentless ache that consumed his every waking moment, and the fear that his life was slipping away, piece by painful piece.

As he shared his story, I couldn’t help but feel a profound sense of shame for my earlier judgment. That is when it dawned upon me that pain, in the context of palliative care, is an intensely personal experience. Each patient’s description of pain is a unique and authentic narrative of their suffering. It’s not for us, as healthcare professionals, to cast doubt or pass judgment.

In palliative care, believing the patient is not merely a professional courtesy; it’s an ethical imperative. We must accept their description of pain, however raw or exaggerated it may seem, as their truth. It’s a reminder that empathy, compassion, and active listening are the most potent tools in our arsenal. We must stand by our patients and provide them with relief from their pain without hesitation or skepticism.

My experience with Mr. X taught me a valuable lesson about the fallibility of my own judgments and the importance of empathy in palliative care. I now approach every patient with an open heart and a listening ear, understanding that their pain, though invisible, is undeniably real. We, as caregivers, must always strive to alleviate that pain, not only through medication but through our unwavering belief in their words and our unwavering commitment to their comfort.



About the Author:

Dr Sidhulal K is a distinguished modern medicine practitioner with a profound passion for palliative medicine. Beyond his medical practice, he shines as a prolific writer, an astute editor, and a staunch advocate for the advancement of palliative care to bridge the gap between medical expertise and compassionate patient support.



Note: This article is a republication from the December edition of the Indian Association of Palliative Care‘s free monthly e-newsletter.

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