The Fear Was Real

The Fear Was Real

Patient: Sanjana

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Palliative care is gradually coming to be recognized as the third arm of medicine. But this discipline of medicine, even more than diagnostic and curative treatments, requires a highly compassionate and sensitive approach to the patient and family, by the treating team. Here is a story that exemplifies the need for a high level of sensitivity.

On the 31st of December, 2020, PALCARE enrolled Sanjana, a 50-year-old woman, diagnosed with breast cancer, which had metastasized to her brain. She lived in a small house with her husband, two daughters, aged 29 and 26, and a 21-year-old son. Upon enrolment she complained about a dull ache all over her body, burning sensations on her feet, vomiting, loss of appetite, weakness, and constipation.

The Fear Was RealHer symptoms were shortly brought under control, by the PALCARE doctor and nurses, who provided her with the appropriate care plan, and additionally, showed her and her daughters how to take care of her breast wound and other such nursing procedures. But, beyond the physiological pain and discomfort, there was something more sinister and heartbreaking that had been going on with Sanjana and her children, especially her daughters. The husband, who was a taxi driver, was a violent man. He had a habit of physically abusing Sanjana, and the daughters. The fear of the husband’s abusive and flippant nature intensified the fear which a debilitating illness, such as cancer, already brings in its wake. More than her illness, Sanjana was deeply concerned for her daughters, and what would happen to them after her death. The fear was real.

Palliative care is an interdisciplinary effort, and in Sanjana’s situation, the PALCARE counsellor became a pivotal point in her care. Through her gentle and patient handling of the psychosocial issues involved, the counsellor helped Sanjana and her daughters to open up and confide about their abusive husband/father. And she learnt that although upon being diagnosed with this dreadful disease, the atrocities on Sanjana herself did reduce to a great extent, the daughters continued to be victims of their father’s abuse.

The PALCARE counsellor was very careful in all her sessions with Sanjana and her daughters in order to make sure that they continued to confide in her as they would periodically go through bouts of guilt and fear that their father would get into trouble. Despite a few attempts to contact him, the husband never responded. With PALCARE’s help the daughters were introduced to SNEHA (Society for Nutrition, Education and Health Action) which has a Program on the prevention of violence against women and children and has an expertise in dealing with such cases. The counselling gave the patient and daughters confidence that they would manage the situation in the future and Sanjana seemed more at ease.

Eventually, Sanjana’s general condition deteriorated, and she breathed her last breath on the 9th of February, 2021. It was a peaceful death. As for the family: the eldest daughter has started work and is back to a healthy routine; the middle daughter will get engaged shortly, after which she plans to go overseas; and the son is shifting to Dubai to work there. And the husband, well, one can only pray that his mind heals too.

*Patients’ names, on this and following pages, have been changed to protect their identity.