There he was sitting in front of me. Dr. M.R. Rajagopal. The fangirl in me could not contain the excitement. He sat behind an unassuming wooden desk, wearing a blue shirt, with his sleeves rolled up. His desk was covered with a myriad of books (one that I instantaneously recognized: When Breath Becomes Air. I’m going to have to dedicate a separate post to this book!) Around him sat a handful of doctors, two of them being Meredith and I. This man has won the recognition of such international organizations such as the United Nations and The World Health Organization. Yet, he sat there, completely humble as he led the weekly reflection meeting. Not only did he humanize medicine, he reminded me why I went into medicine in the first place: to understand this crazy thing called life and to help people.
From this encounter, I began to appreciate to what extent Dr. Rajagopal embodied this concept of “vox populi.” He was a trained anesthesiologist who in the 1980s began to research palliative care. He realized that there was a dark, disgraceful secrete in Indian medicine: there were treatment options for treating a particular disease; however, there were not options for treating pain that was secondary to the illness.
Though India was (and still is) one of the biggest producers of opioids in the world, it did not offer adequate access to opioids for Indians. The reason being was simple: FEAR! There was fear of addiction, fear of overdosing, and a fear of misusing these potent medications. However, Dr. Rajagopal believed that with the right training, doctors had the capability to use these drugs in a safe and controlled environment to alleviate pain and suffering. He spent TWENTY YEARS as an advocate of amending the Drug Act. This law made using and obtaining opioids for medical treatment almost impossible. Dr. Rajagopal’s advocacy helped bring amendments that made it easier for doctors to obtain these medications in treating chronically and terminally ill patients.
During these years, he also started Pallium India, which is a non-profit organization that has since become the World Health Organization Collaborating Center for Policy and Training on Access to Pain Relief. Pallium started out in the southern Indian state of Kerala and now has spread throughout the country. Pallium has a multi-disciplinary approach. It uses a community-based concept to provide palliative care in both large cities and small villages. The doctors and nurses make home visits for the patients who do not have access to transportation. They provide free medications, supplies (ex. beds, walkers, wheelchairs ), food, and home-based physical therapy services for these patients. Pallium also provides training courses on pain management and comfort care to doctors and nurses. It runs workshops for volunteers who are the backbone of the organization and at the front line of defense. They are also the ones that have direct access to the patients in remote villages.
It also provides support summer camps for our amazing little, big fighters who gave up having a “normal” childhood for the sake of taking care of a sick family member. A lot of these children come from low-income families that make ~$5-20 a month. Thus, several of these children leave school to either work or provide care for the sick family member. Pallium has created a system where many of these children can get education grants that allow them to continue schooling. They also provide access to complex care Pediatric clinics where young kids with life-altering diagnoses like cancer, epilepsy, intellectual disability can get a multidisciplinary approach to their care.
The aforementioned services are only a fraction of those that are provided by this organization. The extent of care that Dr. Rajagopal and his team has provided through Pallium is endless! He does not negate the disease. Rather he recognizes that “that the disease needs to be treated, but so does the person.”
“It is someone’s right to be treated as a person and not just as a container of disease.” –Dr. Rajagopal