Writing about oneself is the most difficult part, I realize, because we as an individual are more than our academics and professional achievements.
The existence of the universe was preceded by a Big Bang, birth is a painful process and all good things come into existence following an important event that is turbulent and inevitable.
I joined LLRM Medical College, Meerut in 1981, right after finishing school. My passion was gradually directed towards Anaesthesiology as it was the only branch of medicine which was full of daily challenges. It required a thorough knowledge of all medical branches put together and one had the capability to render a person painless, absolutely numb while undergoing any type of surgical procedure.
Imagine, you go to sleep and then wake up when your appendix, gall bladder or any other body part has been restored to factory setting and yet you do not feel pain at all. The worst kind of pain can be relieved quickly by medical means, but it is a tight rope walk. It is a technique perfected over years of experience, after a lot of mistakes and even tragedies like sudden human loss.
After completing MD in Anaesthesiology, in the year 1991 which was still primitive by today’s standards, I joined the Department of Neuroanaesthesiology & critical care at AIIMS, Delhi. Spending three years in AIIMS, with one year posting in the General Anaesthesia department was an eye opener for me. I had the opportunity to Learn from the best teachers, work in the best environment and get exposed to various advanced monitoring gadgets. The experience and hard work helped me to climb many more stairs of academic achievements later.
St, Stephens’ Hospital in Delhi was the place where I could practice regional anaesthesia in orthopaedics, conduct dozens of cesarean sections in one duty itself, and learn cardiac anaesthesia which was lacking in my armamentarium. This hospital is the birthplace of my elder daughter, it being a reputed place with the most streamlined labour room and fully dedicated staff.
I freelance as an anaesthesiologist in Meerut for many years. Later I took a sabbatical to raise my daughters, a wise decision that took me almost two years to execute. I don’t deny the ambitious trait in myself but my family needs were a priority then.
I had a professional rebirth in the form of an offer to join Muzaffarnagar Medical College, a private medical college, with a small department of Anaesthesia. I worked there from November 2011 till June 2016.Daily commute on a risky highway in bad weather and prolonged duty hours were taking a toll on my health. Moreover, I was in the middle of an Executive programme in Healthcare Management at Indian school of Business, Hyderabad. The course curriculum introduced me to undiscovered aspects of medicine like Laws and Medical ethics.
By the end of this intensive course I had enrolled in a Diploma in Medical Bioethics at PSG Coimbatore. Human Rights diploma from IIHR, Delhi and Certificate course in Bioethics UNESCO were meaningful learning opportunities.
Business and Corporate Laws, an executive programme from IIM Kolkata caught my interest and I could complete it sitting amongst the batch of top lawyers and company secretaries.
All these were aimless wanderings and often I was asked by well wishers what I was aiming for with these fancy degrees, wasting money and time unnecessarily. I had no answer.
I enjoyed the challenges of staying afloat with some purpose to reach a small goal in near future, the road ahead was not defined yet but I kept on polishing my skills. I accepted the fact that most of my colleagues in these courses were half my age and really could do better.
My younger daughter was going through the crucial phase of ICSE and ISC, followed by coaching and NEET. She joined MBBS in a medical college in August 2019.
I joined a group of Humanities in Medicine, by UCMS doctors and students and it seemed to interest me immensely. It was in 2019 that I met Padamshree Dr Rajagopal sir, from Pallium India, Trivandrum in the month of September. Sir is a pioneer in Palliative care in India. This was a stroke of destiny, as at that time I was in deep agony and did not know how to cope with the impending loss of a family member.
My younger sister, almost like a child to me, was suffering from Breast carcinoma and was terminal. Occasionally she would tell her misery in measured words but it was enough to pierce my soul. I had all the qualifications to treat patients who are suffering because of pain and only a bit of training was needed.
I expressed my keen desire to learn palliative care from Dr Rajagopal and he offered me to join the upcoming certificate batch in Palliative care in November –December 2019.
Honestly, I was clueless about palliative care, though I had a vague idea that it is related to morbidly sick people, but then what all does a doctor do?
We are taught to be intensivists, losing a patient under our care was presumed to be a failure and prolonging life was our mission. There was a lot of unlearning and relearning involved in palliative care training. I went to Kerala with an open mind and it was a life changing experience.
Accepting death gracefully, talking about limitations of staying alive, considering huge medical expenses involved in prolonged treatment of some diseases which do not relent, and providing guilt free cost effective painless end to the individual was taught hands on.
Language was not a barrier, home visits, seeing patients in their own environment, providing emotional and mental support to the family, preparing for the final departure were not easy to learn.
Pallium India was a changed perspective from the point of view of a clinician, whose duty is to save lives and nothing beyond the physical existence matters. I realized that there was more to learn about pain free existence. On my way back in December 2019, as I was waiting for my cup of coffee, contemplating how to complete the spectrum of pain and palliative care training, I heard a familiar voice asking for a cup of coffee. To my amazement Dr GP Dureja, the best pain specialist in India, with years of experience and a senior since AIIMS days was there returning from a conference. I joined him a month later to learn conservative and minimally invasive pain relief methods at Delhi Pain Management Centre.
I was fortunate, both these courses of Palliative care and then Pain management were the last offline course as Covid was soon spreading in India too. I was home before the lockdown was declared and then Covid held us hostage for a long time. Books and online learning kept me sustained till I could plan a clinic based on whether Covid disappears and our life comes back on the right track.
Searching a suitable rented place for the clinic was a real challenge as I was keen to provide all pain related services under one roof. Finally, the present setup was rented. It took almost eight weeks to convert the dilapidated premises to its presentable state.
The unit started functioning on 15th of February 2022, there is still much more that can be done as the present facility is Day-clinic. The awareness about pain conditions and benefits of palliative care is still hazy to the medical fraternity and general public. Patients are swayed by alternative therapies that claim magical results. Often they are not able to take regular treatment for various reasons.
The personal approach towards patients by me has mellowed down over the years and I have learnt to accept idiocies of the human mind and their decision making capacities when one faces a serious health issue.
Being responsible for your own health status, keeping in mind the inconvenience caused to family members because of one’s own carelessness, prevention and early diagnosis of incurable conditions, so that one can accept the truth and make appropriate lifestyle changes, accepting the inevitable end gracefully, these are some of the sensitive topics we avoid talking about but can be introduced gradually.
My future aim is to start a palliative unit with good basic facilities and a caregiver training programme as we shall be facing the pandemic of of elderly, bed ridden, home bound or bed bound population in a few years time.
Thank you.
Dr, Sangeeta Goel MD