This divide was a contributing factor to why palliative care, where a “whole person” is treated rather than just the ailment, was not used in modern medicine - a divide doctors now hope to bridge.
Speaking on the sidelines of a lecture held at the UKZN Nelson Mandela School of Medicine yesterday, Dr MR Rajagopal, described as the “father of palliative care” in India, and said to be one of 2018’s Nobel Peace Prize nominees, said palliative care needed to be actively encouraged.
He was in Durban as the keynote speaker at the 3rd International Children’s Palliative Care Network conference.
“When I started medicine 50 years back as a student, we only had X-rays to work with. I had to get the patient’s history with a proper examination and questioning, which meant more interaction with the patient, and more time spent with them. We found out lots of details about the patient. We used to sit down and listen to their stories.
“Nowadays, however, we have technology, which helps make our work more efficient and accurate. But as a doctor I am not looking at my patient.
“I am staring into my screen making an electronic health record, and I listen for just a minute, type in the symptoms and sign you off for an MRI, as an example,” he said.
The advent of technology, said Rajagopal, took away the “detective work”, leaving doctors and patients “disconnected”. “Another issue with technology is that when medical facilities invest so heavily in a machine, they have expectations of the amount of use they need to get out of it, so there is a commercial interest as well,” he said.
“We are relying heavily on technology to do the work, which is not essentially bad. However, an MRI cannot show or diagnose a person’s fear over an issue that could be leading to physical symptoms. That can only be deduced from speaking in detail to a patient.”
Rajagopal’s extensive work in advancing palliative care has led to changes in policy in India’s health-care system, and he is the founder chairperson of Pallium India, a palliative care non-governmental organisation based in Kerala, India.
A documentary about his life and work, titled Hippocratic - 18 Experiments in Gently Shaking the World, was produced by an Australian agency.