Earlier this year, Edinburgh University student Yunus Gokkir was announced the winner of the first St Columba's Hospice Care Medal in Palliative Medicine for Year 5 Medical Undergraduates. The competition was based on an essay submission of 500 words on the topic 'What does Palliative Medicine mean to me'. The full winning essay, 'The Cloakroom' is below. Congratulations Yunus!
Most words you come across in medical school have Latin or Ancient Greek origins which makes it easier to understand how the medical word we use today came about. For instance, nephrology comes from the Ancient Greek word for kidney, ‘nephrós’. I never really gave much thought to the word ‘palliative’ before I was due to join a palliative care team as one of my placements this year. I looked up the term the night before my placement; it comes from the Latin word for cloak, “pallium”. Weird, I thought. It wasn’t a term that described an organ, a pathological process, or a specific characteristic of the patients the specialty cares for. Some have proposed that it is because palliative care ‘cloaks’ the symptoms and the pain of the patients.
After spending some time with the palliative care team and their patients, I think I understand now. The way I see it, palliative care is the cloakroom. It’s where you go when before you leave the ‘party’ of life. You might have been here for a while now— you’ve talked to most of the people that seem mildly interesting, the songs on the speakers are starting to repeat, and the wine is all but finished. So you prepare for your departure. You get to the cloakroom to gather your things, put on your coat, find your umbrella, but essentially, you go to the cloakroom to prepare. To prepare for the outside. From a small window on the wall that the rain is pattering on, you catch a glimpse of it. The outside. It looks dark and wet. You are naturally anxious about leaving but the cloakroom is staffed with the most helpful and sympathetic members who are there to help you. The cloakroom is not interested in how the party went—it’s there to look after your things. If your coat seems to have vanished, the cloakroom won’t ask you how you found the food at the party. They will look for your coat. Similarly, palliative care is interested in treating symptoms, not curing the cause. If you have pain, palliative care is interested in alleviating that pain and not, for instance, whether you are responding to treatment for a terminal illness.
It is important to note that going to the cloakroom does not necessarily mean you are leaving the party. You might be getting something out of your coat’s pocket or maybe you’re putting in a layer of clothing that you took off after taking part in the ceilidh. Similarly, palliative care does not mean the person is receiving end of life care. Palliative care can go hand in hand with other treatments that aim to treat the cause of the disease. When I hear palliative care, I think a safe space. I think ever-so helpful staff. I think a place which provides service indiscriminately. I think a cloakroom.
by Yunus Fazil Gokkir