A few months ago a colleague asked me, why do palliative care people need to counsel patients that much?

I said, “Yeah, we need to tell them what to expect. It’s not easy to prepare someone for the worst. Sometimes we need to talk to them several times.”

“Why can’t you just say ‘just accept it, your loved one is going to die’?”

“It’s not as easy as that, you see. You have to be sensitive and empathic.”

“Well, who wouldn’t understand that someone is dying?”


Guess what? It’s easier to tell patients that way. You’re in a hurry. You have so much other things to do than to sit down with someone and tell them that things are not looking good. You have resus case. Fine. But that doesn’t mean you should underestimate the value of a good counselling. And you’re telling me that palliative care people are jobless.

Let me tell you this. My personal experience is doctors are the LAST people to accept that their loved one is unwell, that they are dying, instead of being in sepsis/electrolyte imbalance/effects of morphine etc. And they are asking me what’s the point of counselling? They wonder why is it so difficult for patient’s relatives to accept that the patient is very ill..

Keyword is empathy.

Empathy and more empathy.

Yes, I found that doctors ask the most questions. Sometimes doctors don’t understand things as well as laymen. We don’t mind answering each and every question.

Do they think that we sit there and listen and talk because they are doctors?

Absolutely NOT!

Everyone is important. Everybody is special. They are ALL our responsibilities. We answer doctor’s questions the way we answer other people’s questions. If we spend 20 minutes with you during a review, do know that we have spent 20 minutes with other patients/relatives too, no matter whether they are lawyers, CEOs, artists, cooks, lorry drivers, housewives or doing odd jobs.

Everybody needs to be listened to. All worries need to be addressed. Yes, some problems we may not be able to solve completely, some not at all. There are things we could help out with, but there ARE things that just need to be faced with a strong heart and listening ears.

I know, we palliative care people don’t do heroic things. We don’t ‘save lives’ the way others do. We don’t resuscitate. We don’t even put IV drips most of the time. But what’s the point of resuscitation when you can’t even tell the family members WHY the patient needs resuscitation at that time, and WHY did the patient collapse at the first place? What’s the point of the heroic action if the next word you say to the anxious relatives causes your hospital to be sued (even though you do all the right things)?

So please…

I know, we listen, we talk. We talk a lot. Do you really need to ask again why, do you really need to ask again, is it necessary, when all you need to do is put yourselves in those people’s positions?
I present to you again, 21 Guns by Greenday:

Do you know what’s worth fighting for?
When it’s not worth dying for?
Does it take your breath away
And you feel yourself suffocating?

Does the pain weigh out the pride?
And you look for a place to hide?
Did someone break your heart inside?
You’re in ruins

One, 21 guns
Lay down your arms, give up the fight
One, 21 guns
Throw up your arms into the sky, you and I

When you’re at the end of the road
And you lost all sense of control
And your thoughts have taken their toll
When your mind breaks the spirit of your soul

Your faith walks on broken glass
And the hangover doesn’t pass
Nothing’s ever built to last
You’re in ruins

Did you try to live on your own
When you burned down the house and home?
Did you stand too close to the fire
Like a liar looking for forgiveness from a stone?

When it’s time to live and let die
And you can’t get another try
Something inside this heart has died
You’re in ruins