Palliative Care: A Haven of Calm in Terminal Illness

CITY — May 10, 2024 —

The palliative care unit at Hvidovre Hospital, just outside copenhagen, offers compassionate care to terminally ill patients. in April and May 2024,this reporter witnessed firsthand the dedication of doctors and nurses providing relief from physical and emotional suffering. Here, support and comfort, including a focus on the patients, is the core mission. Read on to learn more about this critical health topic.

Hear’s a rewritten version of the article, focusing on clarity, flow, and emotional impact, while maintaining the original information:

In the quiet of Room 126: A Glimpse into Palliative Care

The first evening of May settles softly over Hvidovre Hospital, just outside Copenhagen.In the palliative care unit,Room 14,René Damgaard,67,lies in bed.A window is open, inviting in the gentle air and the melody of a blackbird.

“This is the weather you love,” says Mette Damgaard, René’s 53-year-old niece. She leans close, her face inches from his. “The kind of weather for fishing at the sandbank.” She’s been at his side for hours.

René’s eyes are closed, his mouth slightly ajar. The fading light illuminates his thin face. He appears to be sleeping, but he is not. He is dying.

“I will take care of you,” Mette whispers, her voice thick with emotion.

He manages a nod. She gently strokes his hand, squeezing it reassuringly.

“You can let go now, René.”

A moment of profound silence hangs in the air. Then,a faint whisper: “Remember to say goodbye to everyone for me.”

“I will, René. I promise.”

the way we approach death is a subject of intense debate in Denmark, mirroring discussions in the UK and many other nations. The Danish government is considering introducing medical aid in dying, a proposal that has sparked considerable discussion. Palliative care is frequently enough presented as an option, focusing on comfort and support rather than hastening the end. This reporter was granted access to Section 126, the palliative care unit at Hvidovre Hospital, for ten days in April and May 2024, to witness firsthand the care provided to terminally ill patients.

Unlike other parts of the hospital, Section 126 is not about cures. It’s about relief. Here, patients like René receive specialized care from doctors and nurses trained in palliative medicine, managing pain, nausea, and other debilitating symptoms. But their work extends beyond medication. They also guide patients and their families through the complex emotions of saying goodbye, the fear of death, and the pain of leaving life behind.

“Many patients are referred to us for physical pain, but they also experience breathlessness, anxiety, and existential suffering. We call this ‘total pain’,” explains Dr.Johan Randén.Randén, originally from Malmö, has dedicated over a decade to palliative care. He notes that some patients initially consider assisted dying upon diagnosis. “Some think they want to end their life then and there, and might as well get it over with. But they can also live. And I find that when they receive the right support, they let go of that thought.”

Sigrid Nielsen, a 65-year-old nurse with years of experience, adds, “It’s healthy people who want to introduce assisted dying. But the patients we meet here want to live. They do not want to die.”

Each morning in Section 126 begins with a staff meeting. Doctors, nurses, the unit’s psychologist, and social worker gather to discuss each patient’s needs. One man is in excruciating pain; another needs hospice placement; a third requires a Polish interpreter. Then there’s a man in deep psychological distress, consumed by loneliness and a constant need for human contact. “He is really in a deep crisis,” Nielsen says.

He isn’t psychotic or suicidal, but he desperately needs someone to listen. “We can’t change his life circumstances, but I’ve told him: ‘You need to stay here until you feel safe’,” she explains.

The psychologist has scheduled an appointment, and the man has been offered the opportunity to speak with a priest. After the meeting, the team disperses, responding to alarms and preparing for rounds, some heading out for home visits with the mobile palliative care team.

A Personal Touch

outside Room 14, a small, handwritten sign reads “Welcome René,” accompanied by a drawing of a tree.

René arrived on Monday morning from the pulmonary unit. His eyes appear large in his gaunt face, his hair slightly disheveled. His bones are prominent, his muscles diminished. Back pain had started before Christmas, initially dismissed as a herniated disc. Fatigue and chills followed. In late March, severe pain led to an ambulance ride to the hospital, initially suspected as an intestinal obstruction.

“But then they found cancer everywhere,” he says, the disease originating in his lungs and spreading to his liver and bones.

Nielsen enters, gently reminding him to drink more. He promises. “As long as it’s only water,” he jokes, revealing he quit drinking in 1996.”well done,” Randén replies, sitting on the bed to discuss how they can definitely help. René describes his shortness of breath,lack of appetite,and the burning pain under his shoulder blade.

(Image of rené Damgaard with his niece Mette.)

“I know what’s going to happen,” René says, his voice resigned.

“What’s going to happen?” Randén asks gently.

“my life is coming to an end.”

“What do you think about that?”

“It’s too early, but it is not up to me to decide.”

He declined chemotherapy, knowing it would make him feel worse. “I’d rather spend my time feeling good,” he says, unsure if he has weeks or months left.

Randén understands.”That’s not how you should spend your energy.”

He emphasizes the importance of addressing pain promptly. “Pain is like fire. You can easily blow out a candle. But if the fire spreads and the whole kitchen goes up, it’s hard to extinguish. It takes time for the medicine to work, so you need to tell us as soon as you feel the first flame.”

René nods. “I’ve never been good at asking for help,” he admits.

Once the pain is managed, he hopes to return to his apartment, which his niece has prepared for his final days.

“Do you have any children?” Randén asks.

“I have a son,” René replies.

“Do you have a good relationship with him?”

“No.”

“Does he know you’re sick?”

“No.”

In the hallway, Randén suggests to Nielsen, “Maybe we should ask René if he wants to write a letter to his son.”

The Importance of Listening

Randén believes that listening is paramount.

“You can run all kinds of blood tests and scans, but if you don’t talk to the patients about what they want, it’s pointless. You must talk to them. And touch them,” he says.

He and his colleagues have observed that patients frequently enough haven’t had open conversations with other healthcare providers about the potential trade-offs between extending life and diminishing its quality, especially near the end. “Many doctors shy away from talking about death. They keep treating the patients until the very last moment before they finally say: ‘Now there is nothing more we can do.’ But then there is no time left for the patient to prepare themselves for death,” Randén explains.

He believes there are three crucial things a dying person should have the opportunity to say: “Forgive me.I forgive you. And I love you.”

Finding joy in the Small Things

“Life is too short for bad coffee,” declares Niels Abrahamsen,63.

He carefully pours freshly ground coffee into a glass pot, savoring the aroma. “Ahhh.” A box of luxury chocolates sits on his bedside table. Life is also too short for bad chocolate.

Abrahamsen, a self-proclaimed bon vivant, uses this phrase frequently enough. Diagnosed with stomach cancer in 2020, he maintains hope despite his terminal prognosis. After a stomach bleed and radiation therapy, he experienced severe pain. Fluid buildup in his abdomen led to his admission to the palliative care unit.

Abrahamsen embraces a holistic approach to his illness, surrounding himself with “exquisite” dietary supplements. He dislikes medication, especially chemotherapy, which he has undergone extensively. He appreciates the palliative unit’s atmosphere compared to the chaotic gastro unit.”They are more professional here, more experienced, and they have time to sit down and hold your hand,” he says.

he has made his room pleasant with a yoga mat, magazines, and a Bluetooth speaker for listening to good music. Because life is also too short for bad sound.

(Image of Dr. Johan Randén with Niels Abrahamsen.)

Randén enters to check on him.Abrahamsen’s abdomen is swollen. Randén performs an ultrasound, gently palpating his stomach. They discuss draining the fluid or waiting.

“We’ll take it step by step and see what we can do for you,” Randén says, quietly patting his hand. Abrahamsen begins to cry.

“What’s happening?” Randén asks.

“It’s you, Johan. You are the most attentive doctor I have ever met,” Abrahamsen says, covering his face with his hands.

“It’s not easy, I know,” Randén replies.

A Haven of calm

The nurses move quickly through the corridors, but their pace slows when they enter a patient’s room.

They speak softly, taking their time. Patients and relatives often comment on the unit’s unique calm, a stark contrast to the rest of the hospital.

One afternoon, a middle-aged man delivers two large boxes of cream puffs to the nurses’ office. His wife died in the unit a month ago. They had been admitted together.

“We had talked about her coming home to die, but she felt most secure here,” he says. He wants to express his gratitude. “I promised my wife that I would come back and properly say goodbye to the staff.” But walking through the door was tough. “This is where I saw my wife for the last time,” he says.

He shares coffee and conversation with two nurses, one placing a comforting hand on his shoulder. His eyes fill with tears.

“We don’t just take care of the patients