2. Narrative on Pain Suffering and Relief 279
the cost of treatment, and sometimes family mem-
bers are forced into the role of caretaker, having to
perform tasks that they never expected of themselves.
Others are forced to leave their jobs only to increase
the family’s financial burden, passing on a debilitating
debt to future generations. And worst of all, standing
by as disease shows its ugly face and threatens their
loved one with the possibility of dying an undignified,
painful death. When this happens there is no place
to hide. Pallium India refuses to accept this unfor-
tunate and unjust fate of people burdened by these
situations. With the help of donations they are able to
extend medical care into the community. It is an enor-
mous responsibility to shoulder, but one that has the
proven power to relieve not only the patient, but also
the family, of potentially destructive physical, mental,
and emotional pain.
To grasp the complexity of managing a life-limiting
or life-threatening illness and the enormous impact
Pallium India has on the lives of these people, we trav-
eled daily with doctors and nurses from the organiza-
tion to observe their work in the community. Often we
were packed tightly into a small van that at times felt
like the inside of an oven if it was left idle for long pe-
riods. We traveled for most of the day through heavily
congested city streets and on small village roads, that
arguably could be called anything but, to monitor and
treat patients in their homes and various inpatient and
outpatient clinics. Some of these homes were difficult
to access, sitting atop hills or on rocky, unstable ter-
rain. However, by bringing highly qualified doctors
and nurses, good treatment, and effective medicines
to those who either cannot afford transportation or do
not have the physical strength to make the trip to the
hospital, these efforts significantly helped to decrease
their worries.
In each home, each patient was tended to as if they
were the only person being treated that day. I wit-
nessed first hand a wholesome approach to medicine.
And I came to understand that to treat patients as a
whole means to address not only the physical com-
ponents of illness, but also the mental, social, and
spiritual components of the person, as well as their
family. I watched intently as doctors and nurses sat
near the patient, making certain to establish a com-
fortable rapport, one of equality and gentleness. We
listened as patients and family members expressed
fears, concerns, and hopes. Patients appeared to feel
safe under the care of Pallium India. Even those who
were ill fated, abandoned by family because of so-
cial pressures from stigmas associated with their dis-
ease or disinterest in being a caretaker, even they
could muster a smile and were happy for the com-
FIGURE 1. American premedical student Alex Macy and Dr.
Sithara tending to a young patient at Sree Avittom Thirunal Hos-
pital for Women and Children, where Pallium India has a newly
established pediatric palliative care clinic.
pany. There were also many homes filled with fam-
ily members who wanted to help. They welcomed us,
offering seats and a cup of tea, curious about why we
were there. Even in the midst of so much sadness and
confusion, they showed us the best of hospitality.
It is difficult to piece together the right words to
express my gratitude and appreciation for all that I
learned and all that I felt throughout my time in India
and upon returning home. My mind was opened to
an entirely new world. It was a refreshing experience,
one that invited new thoughts, ideas, and beliefs. My
time spent learning from those at Pallium reminded
me to recognize signs of peace even in chaos, to listen
well to peoples’ stories, and when treating patients,
to do my best as a prospective medical practitioner to
add life to a person’s days not merely days to their life.
Ironically, it seems that the United States, with a
health care system in a current state of disarray, has
finally begun to recognize the importance of a ba-
sic and simple approach to medicine, concepts and
practices that have long been used in the develop-
ing world. The focus has shifted towards making bet-
ter use of resources and training health care pro-
fessionals to be well-rounded practitioners, an even
mix of scientist, humanist, and spiritualist. The ironic
part is that much of these developments are a reflec-
tion of what I learned in India. As I have discov-
ered, time and again, that when two cultures meet,
the world as we know it grows smaller, more con-
nected and we can all benefit by learning from one
another.
Declaration of interest: The author reports no
conflicts of interest. The author alone is responsible
for the content and writing of the paper.
C 2012 Informa Healthcare USA, Inc.
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