Friday, February 22, 2013

The Palliative care team

Yesterday morning we went out with the palliative care outreach team which was a window into a world of extraordinary suffering and reminds me anew how goddam lucky we are to live in a country which, whilst perhaps being less inventive, is better at looking after its most vulnerable. Yet, even amongst the ashes of despair and hopelessness there are extraordinary sparks of vitality. India is a country in which one never stops learning inventive and ingenious ways of doing things. The familiar is turned upside down to reveals its bloomers, probably made from recycled umbrellas.

In this country chewing betel & paan is very common. For years men & women hold masticated toxic leaves in their mouth, with their delicate cheek tissues soaking up the carcinogenic chemicals. As a result of this, disfiguring, fungating, destructive tumours of the mouth are common. One of the patients the palliative care team visited had this type of cancer. She was 67 & the whole right side of her face resembled a mine field after someone has driven a tank through it. She was unable to drink because any liquid dribbled out of the hole in her face; that which made it to the back of her throat was misdirected by the tumourous growth into her windpipe causing her to hack and cough. The malodorous flesh passed close to her now exposed olfactory system. Her daughters tended to her as if she were a delicate flower, it was clear they did not want to lose their mother, yet they wanted her to pass peacefully with dignity and without suffering. They were quiet, calming and efficient, yet never forgot their instinct for hospitality, plying us with cold drinks, tea & biscuits as they intently watched the nurse showing them how to dress their mother's wound.

The nurse used a sterile pack with cotton dressings, but these are expensive for the average indian family. So the nurse explained how to make a home made dressing pack. Firstly, place the cleaned steel equipment in a pressure cooker and cook for 10 minutes. The put 2 tsp of salt into a pan of boiling water & bring to the boil for 10 and allow to cool. For the dressings, cut a clean cotton sari into pieces and sterilised them in the idli maker. An idli maker is a steamer in which makes the breakfast rice patties are cooked.

During this process, the lady was barely able to register our presence, she had her eyes downcast. The only sign of acknowledgement was as we arrived and saw her horrific plight, she raised her hands to the sky and looked at us - despairing, begging. It was our turn to have our eyes downcast. Who could deny the justification of her unspoken request? At the end of the visit, the christian chaplain, part of the multi-skilled palliative care team, stood with her, a muslim, embracing her faith and desire to be reunited with God by praying with her. Even I, a non believer, silently prayed that God might hear her.

1 comment:

Sally Whittingham said...

Another powerfully moving encounter Arabella. What you say of the daughters' behaviour reminds me of when we were visiting the dying Nagadevi, who had been such a spirited force as leader of her village SHG. She herself, wasted, in dire pain, half rose from her thin mattress to tell her daughter to make us coffee and to show us the hospitality which is ingrained in this culture.