Dr M. R. Rajagopal writes:
Our dear Jo, Professor Jo Eland, is no more.
She came into our lives, sprinkled love abundantly, conquered our hearts and now she is gone. She died in the morning of the 25th of September, 2016.
In December 2009, she led a group of young students from Iowa to us on a cultural immersion program. And slid beautifully into our lives. She faced problems; Lord, plenty of them; and taught us a lesson in equanimity in the way she dealt with them. And thereafter she would come at the end of every year, a new flock with her to whom as well as to us she gave of her love in abundance.
Initially for me, she was just a loving Professor of Nursing; but I did not know much about her. Then while attending a discussion at a meeting in New York I heard one of the participants speaking about a landmark study by one Professor Eland! I looked her up, and sure enough, there it was, the pioneering work on pain in children. And that was not the only time. Her name would pop up in discussions in various parts of the world, almost unfailingly whenever pain in children was discussed.
An avid photographer, she would capture things that most of us would never see. If you would like to see a sample, go to http://joeland.smugmug.com/Outside-the-United-States/India-20132014
As a mentor, if there was a problem somewhere, Jo would quietly find and fix it. I remember once, soon after their arrival in Trivandrum, the girls in the group all went on an excited shopping spree – except one who had no money. She had scraped together enough to come on the trip, but had none left for luxuries like shopping. Jo pressed some money into her hands and made sure that she had as much fun as the others.
For all of us, end of December every year was a time to wait for Jo and her new team. And then one year, she wrote that she had cancer. “But I will be there”, she assured us. She would manage the three weeks with us in between chemotherapy sessions. And she continued to come every year. Two years back she introduced Dr Ann Broderick to us with the team. In her thoughtful way, I now realise, she was ensuring that the visits and the mentoring will continue.
Dear Jo, you have taught me acceptance with courage. You dealt with the inevitable end as philosophically as the disease and treatment. We will miss you Jo; we will miss you a lot.
If there is a somewhere out there, I shall see you there. Until then, good bye dear friend.
In a renewed effort to gain for all of us the right to live with dignity even with disease (and to die with dignity too), a group of people got together on 18 September 2016 at Changampuzha Mandiram, Sahitya Academy, Thrissur to discuss Government of India’s draft law for protection of terminally ill patients and medical practitioners. There was active participation in the proceedings by patients, family members, doctors and several interested others.
The event was organised under the joint auspices of the Pain and Palliative Care Society Thrissur, Pallium India and Indian Association of Palliative Care (Kerala).
The participants demanded that the draft law must be amended to ensure the following:
1. Any advance directive (living will) made by a competent person in accordance with the provisions laid down in this law must be binding on the medical system.
2. Those who decide against artificial life support must be offered palliative care by the medical system, and
3. The provision in the draft law for having to approach the high court for permission to withdraw life support must be removed in favour of more practical provision for decision by institutional ethics committee.
Ibuprofen, Diclofenac, Aceclofenac, Piroxicam and many other NSAIDs (Non-steroidal anti-inflammatory drugs) can have serious consequences if the prescribed dose is exceeded or if they are taken in situations where there is risk of kidney disease, bleeding or erosions in the stomach wall. And this becomes particularly dangerous as mosquito-borne viral fevers are becoming rampant. See the news in Times of India of Sep 16, 2016. (Thank you Mr Hamza for calling this to our attention).
This is not to advise anyone to avoid all pain medicines.
Pain itself can be harmful. This is only to remind everyone that unlike the much-feared oral morphine which is very unlikely to result in life-threatening situations, inappropriate consumption of NSAIDs can be dangerous. (Well, that is certainly not to say that oral morphine is recommended in these viral fevers either. It is not).
So what should one do?
- Take pain-killers only on doctors’ advice.
- Avoid NSAIDs beyond the prescribed dose.
- Take a medicine that your doctor would prescribe to avoid stomach trouble whenever you are taking NSAIDs.
- Avoid NSAIDs in any situation when there is not enough water in the body (like when one has vomiting or diarrhoea, or when one is unable to drink enough water).
- Avoid NSAIDs in any situation in which the kidney is not functioning properly.
- Avoid NSAIDs in presence of any tendency for bleeding.
Venue: Kerala Sahitya Academy, Changampuzha Mandiram, Thrissur.
Dr E. Divakaran invites you all to an event jointly organised by Pain and Palliative Care Society, Thrissur, Pallium India and Indian Association of Palliative Care (Kerala) to discuss the proposed End of Life Care Law. Prof. C. Raveendranath, Hon. Minister for Education will deliver the inaugural address.
There certainly needs to be more public awareness to a serious malady that has affected medical practice in India – the tendency towards over-medicalisation of death and of torture in an intensive care unit. As the co-ordinator, Dr E Divakaran says, “If somebody with an incurable disease would like their end to be amidst loving family, the medical system must facilitate it. If someone expresses a desire against a tortured death in isolation, in an air-conditioned intensive care unit with a tube in every orifice, that desire must be respected.”
If you are in Thrissur or nearby, do please attend the event.
Contact: Dr E. Divakaran, 94473 08707
How to Apply
Application can be made by filling this form online along with the references and verifiable evidences through media and pictures in order to identify the leadership of the applicants/ nominees to be sent by email to firstname.lastname@example.org.
Last date of Application is Midnight (India Time) of 7th November 2016.
PALLIATIVE CARE AWARD – 2016 will be given by His Excellency the Governor of Uttar Pradesh during the “Conference on the Role of Spirituality in Palliative Care” to be held on 8th December 2016 at Lucknow and Cheque of ₹1,00,000/- will be presented at the 24th International Conference of the Indian Association of Palliative Care- February 2017 to be held at Coimbatore India.
Cancer Aid Society is an NGO in Special Consultative Status with United Nations ECOSOC, working across India since 1987 on Palliative Care, Advocacy, Prevention and Control of Tobacco, Cancer and other Non Communicable Diseases.