Palliative medicine is such a complex and amazing field – it is where the art of being human and the art of medicine truly come together. Palliative care doctors constantly face patients with life-threatening illnesses. And it is not just their patients who need care, family members also need support, as their loved ones are often moving towards the most profound stage of any life – the end stage.
BC’s section head for Palliative Medicine, Dr. Shikha Minhas chose palliative medicine for a very personal reason. She describes the following scenario “A beautiful, brilliant, physician is laying in a bed in the CCU, surrounded by family, monitors, IVs, and the sounds of life saving machines. Even in this time, he has a glint in his eye, a smile on his face and his arms are open in an embrace. Soon this scene is broken by the deafening sound of the word ‘code blue’ and the onslaught of beeping, alarms, paddles and the swish of medication through the IV- this is the fifth time today. The team leaves and the rhythm of his day returns - at least for now. The patient asks questions and extends gratitude, knowledge and hope for the future--- not his own. He knows - even though no one on his own medical team has voiced it - he is dying. In his dying he has shaped many futures including my own - this was my father.’’
In a system focused on ‘cure’ there is often no acknowledgement of an ‘end’. The lack of clear information, the prognosis, and the treatment options are things patients and families face regularly. Palliative care doctors work to ensure patients and loved ones understand the disease and its path. They also help patients to achieve the best possible quality of life right up until the end of life. Compassionate palliative care succeeds when there is a team approach. The team usually includes the palliative doctor, nurses, and other professionals, who work closely with a patient’s primary care doctor.
Like many specialties, there continues to be challenges in service delivery, recruitment and retention of physicians along with fiscal constraints. However, Dr. Minhas notes “we are at an exciting crossroads in Canada. Palliative medicine has been approved as a Royal College specialty. This year, for the first time in Canada, we have a dual credentialing stream - via family medicine and the other via- internal medicine, anesthesia, and oncology. It is also a pivotal time in the country for end of life care and advance care planning. In the face of MAID, we are all determining a new Canadian reality.”