Pain is inevitable, suffering is optional: The resilience of a homemaker

 

On an overcast evening in late September 2024, I hurried into the chamber of Dr. M. R. Rajagopal, Founder of Pallium India, for a discussion. My mind was brimming with research ideas about the Combined Rehabilitation and Palliative Care (CRPC) concept, drawing from my dual roles as a Physiotherapist and Public health professional.

I was greeted by a gentle, soft voice that exuded compassion: “Shall we start our discussion after the inpatient rounds?”. I realised Dr Raj’s unwavering commitment to patients and excitedly tagged along for his inpatient rounds.

In the inpatient unit, I met a 45-year-old woman whom I will call Iris, a flower symbolizing courage, hope and faith. She is a wife and a mother of two adults. As we stepped into her room, she welcomed us with a gentle handshake and a sweet, radiant smile.

Suddenly, Iris clasped Dr. Raj’s hand, bowed her head, became silent for a while and mumbled a prayer from the Holy Bible; then turned to us with a glowing smile and said, “I was eagerly waiting to see you—the man who dedicates his life to alleviating pain and restoring dignity and smiles to those who suffer.” In that poignant moment, my eyes filled with tears—tears not of sorrow, but of joy and quiet pride as we witnessed the beauty of her resilience.

A year ago, Iris began experiencing difficulty in swallowing and started vomiting episodes. She was diagnosed with stage IV metastatic stomach cancer with Krukenberg tumor. With prayers, courage, and perseverance, she completed twelve cycles of chemotherapy, and her condition improved enough for her to carry out her daily living activities independently.

However, by June 2024, she faced a setback and was started on oral Capecitabine (cancer medication to slow down the growth of cancer cells). Soon after, she experienced severe abdominal pain and overwhelming fatigue. Her disease had progressed, and was put on a new round of chemotherapy.

With her unyielding willpower, hope, and desire to live with her family, she decided to complete the full cycle of chemo, but the torturous pain didn’t allow her. The pain became so intense that she could no longer stand upright or lift her head to meet another person’s face. Though her body was ravaged by the relentless pain of cancer, her spirit remained unshaken. She showed unbelievable strength even in the face of unimaginable suffering.

On September 23rd, 2024, Iris arrived at Pallium India, curled up and head bowed down in overwhelming pain. She was unable to look at the faces of her doctors or nurses due to the severity of the pain. She could however recognize them from their voices. She was not able to sleep either. After assessment, need based pain relief medications were started. Her pain gradually reduced. Now she is able to look people in their faces and talk.

Iris was enthusiastic as she spoke about her children’s studies and the joys of raising them. During our interaction, I felt a profound sense of motherhood. I could feel her maternal love pouring out in every word she spoke about her children. It was this deep maternal spirit that led her to affectionately describe Pallium India as ‘Ammakkilikkoodu’ (nest) and described nurses as ‘Ammamar’ (mothers), reflecting the nurturing, warm, compassionate care she received.

Her philosophical insights left me in awe. She said to Dr Raj, “Sir… being able to go to sleep with a smile and wake up with a smile is the greatest blessing in life. (Chirichukond uranganum chirichukond unaranum pattunnathaanu jeevithathile ettavum valiya bhagyam). If we have pain, we cannot smile, and without that smile, life loses its meaning.”

The powerful words of this humble, rural homemaker, shaped by her life experiences and struggles with pain, resonated deeply with me. They prompted me to reflect on the critical role of pain relief in palliative care and how deeply pain can impact a person’s life. This experience highlighted that pain relief through palliative care approach not only brings comfort but also restores an individual’s dignity.

On September 30th, 2024, as she was discharged, I went to say goodbye. She shook my hand, beaming with happiness. “I am leaving”, she said. “Pain is debilitating, but pain relief is liberating.”

From the shadows of pain, Iris blossomed into strength. The light of pain relief restored her dignity, and with it, she was able to reclaim her infectious smile, something most cherished about her.

Iris is a living example of the palliative care assurance: Pain is inevitable, but suffering is optional.

 

About the Author: 
Ms Anjali Krishnan R, is a Physical Therapist and Public Health professional, with a strong passion for Health Policy Systems research and implementation research related to palliative care.  She is currently working as an Officer – Projects and Data in Pallium India, Trivandrum, Kerala. Anjali began her public health career at Pallium India in 2017, where she was introduced to palliative care. She is a firm believer in the transformative impact of integrating palliative care within the health system to enhance the well-being of individuals and their families.

 

Comments

  1. Dr Abu Hasan Sarkar

    This poignant article is well articulated and reflects the true sense of pain and suffering. As a medical doctor and as a family member of cancer patient, I have witnessed the pain and suffering of people fighting with cancer. Palliative care definitely brings hope and smile to the patients.

    I have seen patients who succumb to the pain, and I have seen patients who are resilient. Yes, pain is inevitable, but suffering is a choice! Extremely well written, Anjali Krishnan R. You should write more and help patients and their families to become resilient in the path of fighting cancer.

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