Author: Dr Arshi Taj
Assistant Professor, Department of Anesthesia, Critical Care, and Pain Management
Government Medical College, Srinagar
Every journey begins with a cause. Mine, to be of service to mankind. Albeit it seems clichéd, yet it is true for me.
My journey began in 2016 when I was posted for training in pain management at The All India Institute of Medical Sciences (AIIMS), New Delhi. During that time I was introduced to palliative care under the abled guidance of Professor Sushma Bhatnagar, HOD Onco-Anaesthesia and Palliative Medicine, AIIMS.
My training period provided me with an opportunity to keenly observe how palliative care specialists approached and communicated with patients. I also overcame my fear of using opioids in daycare, and learnt that opioids could be infused intravenously to provide pain relief more effectively.
The team at The Institute Rotary Cancer Hospital (IRCH) were more than happy to make me understand palliative care and pain management. The impact of this training led me to undertake the One Year Nattional Fellowship Programme offered by the Institute of Palliative Medicine (IPM), Kozhikode, Kerala. Each day ignited a new passion within me and set more determination, for me to pursue palliative medicine. The dedication demonstrated by the nursing staff at IPM was also very encouraging and empowering.
A vision was born within me during my visit to The Tata Memorial Cancer Research Centre and The Gujarat Cancer Research Hospital, two centers of excellence. My dream was to establish a Palliative Care Centre in my own homeland, Kashmir.
When I returned home, the determination to provide palliative care to my people in need, was cemented. Though My humble endeavor evoked little public interest in the beginning, it gathered momentum with time. The iniitial meek response became a thing of the past. I began with a handful of referrals from oncologists, who soon realized the benefits of palliative care.This positive response boosted my morale and drive me to take a step forward towards something that seemed impossible. I asked my hospital administration to provide opioids: Morphine tablets and Fentanyl patches for my patients. With their support, I procured these drugs on my own.
Post a couple of years, a colleague of mine also completed the Palliative care training at AIIMS, New Delhi. My dream of establishing a Palliative Care clinic in my hospital was now becoming a reality. After 3 years of unwavering pursuance and requests, in 2019, our hospital opened its first Palliative Care OPD with a 4 bed daycare unit.
During this time, 3 of our doctors and 2 nurses also participated in the Cancer Treatment Centre (CTC3) programme training in Delhi. This strengthened the faculty required towards establishing an efficiently functioning palliative care clinic. Now the clinic has a regular and steady supply of opioids. In a year we took care of 180 patients in our OPD!!
Despite the challenges of a pandemic, we continued and are still continuing to serve our patients either via telemedicine or when absolutely needed even physically.
The journey which I started alone, has now become a mission for many nurses, psychologists, social workers and volunteers. Together, we can make a difference, because ‘There is an end to cure, but there is no end to care’.