Many people are unaware of the branch of medicine known as “palliative care.”  Some, who have sort of heard of it, may think it is the same as hospice care, that when you enter into palliative care, you no longer have medical treatments for serious diseases, and you are on the verge of death. But that is not so. The World Health Organization defines palliative care this way:

”…an approach that improves the quality of life of patients and their families facing the problems associated with life threatening illness, through the prevention of suffering by early identification and impeccable assessment and treatment of pain and other problems, physical, psychological, and spiritual.”

That Good Night: Life and Medicine in the Eleventh Hour, is a memoir by Dr. Sunita Puri, who chose Palliative Care as her medical specialty. She tells the story of her training and experiences in medical school that led her to make that choice. And she shares the experiences she had with patients and colleagues, many of whom were not familiar with the type of help palliative care can give patients and their families, and the kind of help and support it gives the doctors treating those patients. It was an eye opening and very moving education for me about a relatively new field of medicine.

From the publisher:

As the American born daughter of immigrants, Dr. Sunita Puri knew from a young age that the gulf between her parents’ experiences and her own was impossible to bridge, save for two elements: medicine and spirituality. Between days spent waiting for her mother, an anesthesiologist, to exit the OR, and evenings spent in conversation with her parents about their faith, Puri witnessed the tension between medicine’s impulse to preserve life at all costs and a spiritual embrace of life’s temporality. And it was that tension that eventually drew Puri, a passionate but unsatisfied medical student, to palliative medicine–a new specialty attempting to translate the border between medical intervention and quality-of-life care.

Interweaving evocative stories of Puri’s family and the patients she cares for, That Good Night is a stunning meditation on impermanence and the role of medicine in helping us to live and die well, arming readers with information that will transform how we communicate with our doctors about what matters most to us.

My husband, Byron, is now in palliative care while undergoing his treatments for cancer (see my post on his diagnosis). I should probably say that “we” are in palliative care, because family is as much a focus there as is his pain management and quality of life help. It is a very individualized care, with much more direct communication, and the team includes the palliative care doctor, a social worker, and a nurse. And all of this care is in support of his ongoing treatments and of his oncologists and other doctors who are treating him. Our palliative care team is helping Byron to have the best quality of life possible as he fights his disease, and they are providing support and care in helping us make the many profoundly difficult decisions of treatment and end of life care. When Byron’s ongoing treatments no longer work and are terminated, he will be moved from oncology and palliative care into hospice care.

Wise and poignant words from Dr. Puri:

“For we will each age and die, as my father told me years ago. We will lose the people we love. No matter our ethnicity, place of residence, income, religion, or skin color, our human lives are united by brevity and finitude, and the certainty of loss. Just as we strive for dignity and purpose throughout our lives, well before the light fades, we can bring this same dignity and purpose to our deaths, as we each journey into our own good night.”

I highly recommend this book. It is very moving and heartfelt, and it has a positive, uplifting, and empowering effect, overall. For those of us experiencing palliative care right now, it is an important and helpful education.

Dr. Sunita Puri…