Today on World Hospice Day, I reflect on the milestones and changes I was fortunate enough to be a part of in my 50-plus years in medicine - many of which were spent in palliative care.
In the 70s, I was the director of clinical pharmacology at a Brisbane hospital. Working with a passionate PhD student on the composition of morphine, we became increasingly interested in the world of palliative care. I began admitting dying patients under my care on top of my usual clinical load, and was taking home the award for "Longest Ward Rounds" in my cohort. The goal was to build a dedicated academic and clinical unit for dying patients, but the facility wasn't quite ready.
In 1992, I relocated to Newcastle to take up the role of director of palliative care at the Mater Hospital. A facility that had already been providing quality palliative care since the 80s, after being founded by Dr Pamela Harrison and a group of visiting medical officers and nurses. I would call the Mercy Hospice my second home from 1992, the year before the building was complete, up until 2009 when I retired.
When I arrived at the Mater, I was incredibly lucky to have the support of the operational manager, nurse unit manager and allied health staff at the time, to build a multidisciplinary team that worked exclusively at the hospice. Together, we developed a team of doctors, nurses, allied health and administrative staff that grew together in this specialised area. A model that still exists today.
During my time at the hospice, three significant changes in the world of palliative care stand out.
In the mid 90s, palliative care services expanded into Port Stephens and Maitland. It was a big leap forward in increasing access to care in these areas, and other centres followed.
The evolution and quality of local training for medical students is also something I reflect on fondly. From humble beginnings when the university considered medical students 'too immature' to study death and dying, to the hospice becoming the most popular rotation for resident medical officers in the region. This training laid great foundations for the young doctors in managing dying patients.
Another significant milestone was the cross-training of our hospice nurses and outreach nurses - an ingenious initiative of the nurse unit manager. Historically, both cohorts had worked independently. When the decision was made to have outreach nurses work in the hospice and vice versa, a new sense of collaboration, mutual understanding and respect was fostered among the staff.
Today, I acknowledge and celebrate the work of past and present staff and volunteers, and remain optimistic about the future of palliative care, in seeing the passionate and skilled staff specialists, nurses and allied health staff graduating today.
In its 30th year, I believe that the Mercy Hospice is not a place to be feared. It is a place where specialist and holistic care is provided. Where the individual is looked after with dignity and where life is celebrated.
I recall caring for a man in the hospice whose wife had found him increasingly difficult to manage at home. He was remarkably independent and not entirely receptive to the concept of the hospice. We tried our best to care for him, only sometimes successfully intervening and getting him settled.
After some time, he died peacefully and as a 'thank you', left each of the staff a handmade embroidered bear that represented their individual personalities and characteristics. His talent was immeasurable.
To me, he is an important reminder that people can change. That we are constantly growing and evolving. That showing kindness and caring for others is one of the most rewarding things a person can do. That the hospice isn't a place of dying, but living.
