For decades after completing my MD residency and becoming a physician, I held firm to a belief: diagnose accurately, treat effectively, monitor diligently, and ensure that patients followed my advice. This was the creed I practiced in OPDs, wards, ICUs, and even during cross-department consultations in the hospital.
And it worked. Most of the time.
There is no greater reward for a physician than seeing their patients recover, adhere to treatment, and return for follow-ups with gratitude in their eyes. It’s a validation of our efforts, a source of quiet pride, and a moment of shared joy with patients and their families.
But not always.
This young man was an exception. At twenty-three, he ran a teashop in the city, full of energy and brimming with ideas—new flavours, clever promotions, and plans to grow his business. He was a man with dreams. Until one morning, a headache—unlike any he’d ever experienced—changed everything.
A visit to the doctor. A scan. And then, the bombshell.
The MRI showed a massive brain tumour, occupying almost half his brain. The swelling was severe, the pressure life threatening. It bore down on the vital centers controlling his heart and breathing. The tumour was inoperable. Three neurosurgeons—each a veteran—reviewed the case and unanimously declined to operate. Neither surgery, radiation, nor chemotherapy offered any hope. Nothing could stop the tumour’s growth, or so said all the doctors.
And so, he came to us—to the palliative care center. A shadow of the vibrant young man he once was. He struggled to speak, his words broken and unclear. He couldn’t swallow, couldn’t move his left arm or leg. He depended entirely on his family for every basic need—feeding, bathing, turning in bed. A tube nourished him; a catheter managed his bladder.
Days blurred into weeks. The family cycled through the stages of grief—denial, anger, depression, and finally, acceptance. He, too, began to grasp the reality from whispered conversations and tearful silences. We could offer little beyond attentive ears, kind words, and measures to ease his suffering. We focused on sparing him unnecessary interventions and futile medications.
Eventually, he went home.
Yesterday, he returned. Propped in a wheelchair, flanked by his parents and a devoted sister, he greeted me with a faint smile. We exchanged pleasantries. I lightened the mood with a few jokes, asked about his teashop, and teased him about Pushpa 2—the latest movie he might have watched. Our resident held his hand, and that simple human touch lifted his spirits visibly. Minor tweaks to his medication followed, and then came the question.
“Doctor,” his father hesitated, “can I take him to a baba in a remote Rajasthan village? He’s known to cure cancer with miraculous powers. People say he’s healed so many. But there’s one condition: we must stop all modern medicines. The baba insists on sacred rituals—a thread on the wrist, ash mixed with honey. That’s all.”
The room fell silent.
Years ago, my younger self would have scoffed. Dismissed the idea. Maybe even chastised him for suggesting it. But years of practice have taught me otherwise. Desperate times drive people to desperate measures. It’s not just about faith in the extraordinary; it’s love, guilt, peer pressure—all tangled together.
And it isn’t just “babas.” They go by many names: gurus, mystics, healers. Each weaving with their own mix of rituals and promises. Some offer sacred threads and ash. Others recommend exotic herbs or chants to align the cosmos. To the modern mind, it can seem bizarre, even absurd. Yet, to families grasping at straws, these remedies become beacons of hope.
I chose a different response.
“You may go,” I said, carefully measuring my words. “But try not to stop his seizure medications or supportive drugs. You can follow the baba’s advice alongside.”
The father’s eyes welled with relief. Gratitude poured out in his words. This was what he needed—validation of his decision, assurance that he was doing everything for his son.
Sometimes, nobody is entirely right or wrong. What remains is the middle path.
As they left, I watched the family disappear down the corridor, the father wheeling his son out with cautious hope. And I wondered: perhaps the greatest medicine isn’t one we prescribe but the understanding we extend. A touch. A word. A bridge between worlds.
So very true.
Indeed a harsh Bitter Truth !
Helpless and Sad!
Prayers are heard is all I know… sarbat ka bhala🙏✨✨✨
Short of words to comment
God bless.
True sir. And unfortunately we do get so many patients like this. All I say is ” nothing can be done, by anyone and anywhere. Please dont spend any more now in 5th/6th/ Nth opinions, such that the kin have to bear economic loans/losses later”
I still remember the first time I faced death with Avita as an intern .. a mother whose teenage son just laid with her and cried .. and again as an intern myself.. a husband just sat next to his wife as she faded away.. both times there was nothing we could do .. i can still remember their faces .. again with my own parents.. the truth that we are only an instrument of God and should never forget that .. empathy and compassion are our most powerful tools .. and it is our job to provide dignity and strength in disease and death to those we treat.. the rest we have been taught well…
Very true.
Unfortunately not uncommon harsh truth. It may sound culturally inappropriate but sometimes dying with dignity is better that living with false hope. Luckily for us euthanasia has been made legal here few years back. The process is purposely cumbersome. I have had atleast 3 patients with end stage IPF who opted for assisted dying. Of course it requires a high level of health literacy among the population.
No doubt,very harsh truth.Perhaps therefore,the Almighty has taught us to live our lives between “sabr”(patience) and “shukr”(thanking His bounties)….
Once Dr Jajoo was to operate on a guy, & Dr Jajoo asked patients father, that the guy might die, the father refused saying , taking dead body back home wud be expensive.
Dr Jajoo said, all the ethics come to halt in such situations. 🙏
No words.Only prayers.
When i see that the patient is in a state of terminal decline and will not come out alive i try to convince the patients relatives to opt for supportive care only. Residents are instructed to keep investigations and medication to a minimum so that patient can pass away without any more financial burden on the family. If the patient is likely to be in a vegetative state we start training the next of kin about care at home and encourage them to buy air mattress , oxygen concentrator etc rather than spend all their resources on a long drawn out futile stay in the hospital. I think it is the doctors responsibility to help the patient make a decision in such situations because in most circumstances the relatives are so distraught and bewildered that they just cant reach a decision by themselves
Very touching.
We need affordable palliative care centers across. Nagpur had a very good one I remember. Visited in my internship days. Felt the glaring need in my MOship period.
Such one incident that I remember is a couple abandoned their old bed ridden mother and just ran away from their home. Neighbours came to me (as I was the Medical Officer n had helped with few destitutes lying on the road) as stench was coming from the room. Lady was forced to eat her own excreta (Pardon me for gory details). We called up the daughter in law who said do whatever u want, we have exhausted the money n won’t come back.
As she had relatives took time to arrange for some institution to take her as was wary of any action later.
But the lady died a day prior when the organisation was supposed to pick her up….
One thing that never leaves me….
I read what you wrote and thought- Ah, but you did do a lot for that family even when ‘there was nothing more you could do’. You supported the patient and the family, gave them space, listened to them, didn’t do things just because you could, respected their choices and your patient’s dignity. You provided good Palliative care. The goals of care were different, but the team provided care to suit the patient’s needs.
A lot of what you have written in this post Sir around medical school education and training is what I too resonate with. Happy to support any teaching in palliative care ( which happens to be my topic of special interest). I will DM you
Heart touching 🙏
The Dalai Lama has written in the book that ” all Healthcare centres should broadly classify the care into care for the living and care of the dying ” because surely the ones who are dying must receive care that is qualitatively different from other patients. Merely prolonging the process of dying is not good medicine
🙏