Palliative Care lies in between the usual medical culture of active treatment and the culture of death and dying. Was that what attracted me to Palliative Care, having lived as an in-betweener for most of my life? Growing up between two cultures; Chinese at home and mostly Eurocentric outside of home. This continued for me in University being part of the local Chinese Group but also being part of the newer Asian immigrant group. A bridge is needed between the two groups as the two different cultures can be different in many ways, and may think that they have little in common.
Standard healthcare is directed at saving life, curing disease, fixing things which are broken. Death is looked upon as the great enemy, something to be fought against, railed against until the dying of the light. People have to go to battle against their diseases, go to war, but when it comes to your own bodies the collateral damage may be too much too handle.
A previous patient of mine had a similar background in that we were both of Han Chinese origin. Thanks to the Chinese Diaspora and accidents of birth, his surname was spelled using the French alphabet and mine was spelled using the Portuguese alphabet. We were both also members of the Hakka people, the guest people, as we were traditionally the drifters/gypsies of the Han Chinese. The fact that our parents/grandparents ended up in vastly different places and having to adapt to markedly different lifestyles was true to our historical heritage. The Hakka people were sometimes driven out of town by the non-Hakka people so it was not unusual for them to set off on major overseas journeys, ending up in places like Hawaii, Tahiti, East Timor to name a few.
My patient looked as Chinese as I did, but he spoke English with a French accent. His temperament was also more like a Frenchman, full of passion and bluster. Not much whispering going on, when a passionate monologue could say so much more. He had been a Tai Chi master in his past, having taught the martial art over many years. He also had a very different relationship with his cancer.. He did not fight it, and was not trying to destroy it. He said that the cancer had grown as part of him, that he could not go to war with himself, so instead he loved his cancer. He treated it with care and respect as if it was a good friend. He felt that by doing so that he had not suffered as much because of it. There was something about his relationship with his cancer that probably meant that he stayed alive longer than most people with his cancer would have.
How can you be calm if you are accepting as collateral damage, destruction of the non-cancer parts of yourself? There is something wrong with fighting yourself, self-harm harms physically and likely emotionally/spiritually too.
Palliative Care could be an essential part of the journey, akin to crossing the River Styx, from the land of the living into the unknown. Palliative Care can provide a bridge and guidance to people who may soon need to cross over into the land of the dying. What price is the trip across the river, what will you pay the ferryman? What are you willing to let go off in order to support this journey?
Purgatory and judgement is not our role, we are here to ferry you across to the other side in a supportive manner. We aim to make it as smooth a journey as possible, as the currents may be rough on the way. Clear communication is required to ensure a comfortable journey along the continuum between life and death.