Published on: January 28, 2019

Vijesh V.V., Project Officer at Pallium India, writes:

I have seen student magazines dedicated to arts, sports, love and often topics of academic interest. But a student magazine on palliative care is the last thing I expected to see in India in this decade. I am writing to let my fellow palliative care enthusiasts know that Lexicon, an online quarterly medical magazine and blog, born in India and operated by medical and paramedical students, has published their 24th edition, the latest one carrying special theme feature on palliative care titled ‘The cloak that matters’. Lexicon has a consistent readership base of over 25,000 across 250 medical colleges in India and has an international following as well. Integration of palliative care into undergraduate medical education being one of the key strategies of palliative care advocacy, it is indeed an immensely inspiring and encouraging development worth appreciating.

This time the edition is a 76 pages’ read organized judiciously under 16 headings. The edition features articles, initiatives, interviews and photographs. ‘The cloak that matters’ discusses in detail the history of palliative medicine, dignity, empathy, ethics, pain, suffering, spirituality, research, technology and career options in palliative care. A core team comprising of Dr. Amogh Natkarni, Dr. Shreeya Mashelkar, Dr. Anushka Reddy, Dr. Madhura Mandik, Dr. Tuhina Mishra, Dr. Poonam Nayak and Nisarg Kahane spearheaded this initiative. Contributors to the 24th edition include palliative care physicians, general and specialist practitioners, academicians, social worker, a priest and medical students. This is a simple yet thought-provoking read and editors have taken special care to make sure that the content is appealing to the primary readership i.e. students.

When tasked with preparing a summary of this edition, looking at the number of pages and considering a strict timeline, my initial intention was to skim through it and prepare a superficial report. But the novelty and depth of the content made me read the whole document in one sitting. I hope those who are reading this blog post will find time to go through the whole magazine and recommend others to do the same.

The first chapter is on the evolution of palliative care in India. Dr. Vishnu Priya Basham, a specialist general practitioner in Australia eloquently lists the ‘story’ of evolution. Next is a gripping read on the experiences of a young doctor that made her realise where she stood in terms of being a better physician and catering to the needs of patients, in the context of palliative care. She talks about the responsibilities one assumes when he/she chooses to sit in the ‘big black doctor’s chair’.

“When I think of the question of ‘empathy’, I like to think of primeval man; a frail and unprotected creature that lacked the physical skill and ability of the other species that cohabited its world. A creature that used cognitive processing as its secret weapon to survive on a hostile planet; a species that changed the contours of nature to reduce its disadvantages vis a vis predators; individuals that had to band together in groups to protect themselves. For primeval man was social by design, there was no other way for him to ensure his survival”, writes Dr. Abhinav Chichra. In this article; one of my favourites, the author delves deep into the intricacies of empathy and social connect and argues that they are rooted in biological processes.

Dr Anindita Das, a radiation oncologist, poignantly narrates the pain of a palliative care physician:

“I am the gloved, aproned figure.
Today, I do not have the gloves, the apron.
But I am bound to keep this invisible mask. I am the Doctor.
And the Doctor cannot cry”.

Suicide incidence and ideation is rather common among people suffering from life threatening and life limiting diseases. Dr. Shivani Vakilwala, in her article titled ‘choosing pain free life over death’ lists research findings substantiating the achievement of palliative care in reducing suicide incidence. Another interesting aspect of this article is a detailed account of challenges faced by care givers.

Rev. Dr. Arul Dhas, reader, Chaplaincy, CMC-Vellore talks about life, pain, meaning, connectedness, forgiveness and hope in the context of extreme suffering. Another brilliant article written by Dr. Sushma Sivananda, resident physician at National Cancer Centre, Singapore explains the ethical issues involved in palliative care.

A highlight of the 24th edition of Lexicon are the interviews given by three stalwarts of palliative care; Dr. M R Rajagopal, Dr. Reena George and Dr. Robert Twycross. The well thought-out and carefully crafted interviews deal with education and training in palliative care, pain, death, dignity, empathy among physicians and newer generation and healthcare expenditure. Through frequently discussed questions, interviewees offer fresh perspective to the readers. One chapter in the magazine is dedicated to Pallium India. Ms. Chaitalee Ghosalkar, in her article titled ‘Because the patient matters – Pallium India, Kerala’, gives a detailed account of the organization and its activities.

Tech-X, another favourite of mine, written by Dr Amogh Nadkarni from Grant Government Medical College, Mumbai, is about the application of new clinical technology in palliative care.

Please do read the magazine. The 24th edition of Lexicon is available for free download at http://lexiconin.com/latest-edition