Reflection on Complexity at the End-of-Life—More Nuanced than Simply Treating Patients the Way We Would Want to be Treated.
I relocated to the United Arab Emirates just over three years ago, to start a new palliative care service in Abu Dhabi. Palliative care remains a relatively unknown medical specialty here
in the UAE both among clinicians and the public.
As a new team, we were recently reflecting on some of the more challenging situations that we faced since setting up the service. This case reinforces my belief that palliative care is complex, individualized, holistic care and ‘looks different’ for every patient and their family.
A 16-year-old female patient with a tumor of her spinal cord returned to the UAE having received extensive treatment in the United States. Her tumor unfortunately had not responded to
treatment and had spread to the brain and leptomeninges.
She was initially under the care of the medical oncology team before
her care was transferred to the palliative care team at the request of the patient and her family. The patient was well-supported by her mother and brothers and there was always a family member in attendance.
Symptomatically, she complained of headache and back pain which were
well-controlled with standard analgesics. As a result of the tumor location, she started to develop progressive paralysis of all the limbs, lost the ability to vocalize, and developed rapidly progressive cranial nerve palsies.
During our many discussions with her family, we explained the likely trajectory of
her condition and explained in detail, the physical changes that
were likely to take place because of her condition including cranial nerve paralysis, and how this would affect her ability to breathe.
Palliat Med Hosp Care Open J. 2023; 9(1): 7-8. doi: 10.17140/PMHCOJ-9-152
