Opinions 22 May 2023

Palliative care: the hands that reach the in-between places

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Rachel Coghlan shares a poetic reflection on the intricacies and chaos of providing palliative care.

Authored by
Rachel Coghlan

Palliative care physician Dr Sunita Puri wrote recently in The New York Times that “death is never neat”. DrPuri suggests that our most authentic caring for those who are dying comes at the point we are prepared to “sacrifice neatness” and to “stumble through the thicket with them”. Those who work around advanced illness and dying are all too familiar with the messiness that such illness can bring.

And yet, the most oft-used image of dying is of an old, wrinkled hand laying gently in the hand of the one giving accompaniment. This is a picture of death’s serenity and peace: its neatness. These hands are commonly used as emblematic of palliative care, a symbol of the good work we have done to provide this neatness at the end of life. For those of us working in palliative care, these hands desert the full spectrum of things we do to support people to live life with quality long before death comes to pass (see Dr Jared Rubenstein’s amusing satirical video). These hands also do not honestly convey our most important role, not in serving tidy resolutions, but in stumbling through that thorny thicket together.

There are many ways we offer care to those journeying through illness. As we open the conversation on all “Matters of Life and Death” this National Palliative Care Week (21–27 May 2023), our authentic caring must be seen as much in the sometimes chaotic space we hold for hands which grasp for us through the bramble, as in all the practical solutions and tidy words we can provide.

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Pictures of hands are commonly used as emblematic of palliative care, but rarely capture the tension and chaos of the real experience. Body Stock/ShutterstocK

The following poem was written to commemorate Palliative Care week and “Matters of Life and Death”.

Rachel Coghlan is currently undertaking a Fulbright Scholarship at the Johns Hopkins University Center for Humanitarian Health. She is a palliative care physiotherapist and researcher, and a Board Director of Palliative Care Australia.

21–27 May 2023 is National Palliative Care Week in Australia. This year’s theme is “Matters of Life and Death”.

The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the MJA or InSight+ unless so stated. 

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