Tell Me the Truth: Conversations with my Patients about Life and Death
AS A child growing up in the impoverished Indian state of Bihar in the 1980s, Ranjana Srivastava’s first encounter with cancer broke her heart. In what felt like a matter of weeks, the disease transformed her energetic grandmother into a vulnerable, ailing person who spent her last days confined to a hospital bed.
Despite being treated by one of the best cancer specialists in the region, Srivastava’s ”Nanima” did not receive good care. As she was shunted through the health system for a multitude of tests and procedures, her doctors fed only morsels of information to her eldest son, who, despite his best efforts, struggled to understand what it all meant for his mother.
Towards the end of Nanima’s life, the lack of communication between these doctors and her family led to a tragic end. Without knowing her grandmother’s prognosis, Srivastava, then 10, and her mother flew to Britain to visit family. While they were gone, their beloved matriarch fell into a coma and died. She was cremated before they could get back to see her one last time. There were things they wanted to say. They did not get a chance to say goodbye.
[..]”We spend a lot of money on futile medicine and intensive care at the end of life and if we have limited resources like every nation does, we need to be thinking about how those resources are best allocated. I think investing in palliative care and boosting support services for sick people is very important. Those things should not be an adjunct…”