United in Everything We Have Lost
Palliative care physician, Dr. Sunita Puri (@SunitaPuriMD), is the author of “That Good Night: Life and Medicine in the Eleventh Hour.” She recently published an essay entitled, We Must Learn to Look at Grief, Even When We Want to Run Away. Dr Puri will be a plenary speaker at the McGill International Congress on Palliative Care, Oct 18-21, 2022. Dr. Puri was interviewed by Devon Phillips.
Devon Phillips (DP): In your recent essay in the New York Times you spoke about “bearing witness” as an essential part of palliative care. What is bearing witness and what does it mean as we move through and hopefully out of the pandemic?
Sunita Puri (SP): When I first started my medical training the hardest thing for me was to sit still with people as they went through difficult things, things that I could sometimes diagnose and treat, and sometimes I couldn’t. I was trained to do something and not just sit there. And then one of my mentors in residency said, “Don’t do something, just sit there”. And that blew my mind.
To me the core of medicine is to give the gift of being seen, whether the person is suffering from a serious illness or not. That is so much of what bearing witness is about, is sitting with your own discomfort, knowing that the discomfort of the person in your presence is much greater and can be made a little bit less painful if we choose to see them. In palliative medicine that is one of the greatest things we offer. It is in bearing witness that we can figure out who a person is, what their lens is on the world, and that is really what we need to understand in order to help them have the life and the death they want. This involves so much more than diagnosis and treatment – it can mean asking about what you hope for and value in your journey with this illness or it can mean being silent. It’s a moment where you trade fixing for accompanying. That’s what bearing witness is to me.
DP: In the context of the last few years of COVID, you talk about the power of collective grief as a possible point for connection and of bringing people together. Can you tell me more about your thoughts on this?
SP: The tradition in which I was raised says that humans are bound together by the brevity of our lives and also by our suffering. I write about this concept in my book. When you go through life you learn that suffering and pain is something that you need to hide, that it somehow makes you weak or not able to cope. In the pandemic something about this really shifted in our culture. All of a sudden there was more of an allowance for discussions of pain, suffering, loss and grief. During the pandemic, people were talking openly about how their lives were irreversibly marked by the sudden loss of someone who was at the centre of their world. And what a revolution that would be, for us to be united in everything we have lost, because suffering and grief are unavoidable parts of a human life. To turn to the things we previously thought we had to hide and to instead embrace it as something that can unite us in this tumultuous time. This came through strongly to me about what I could offer to the world: what could this moment mean in terms of looking at ourselves as essentially no different from each other, that we are all bound in the granular nature of our humanities, much of which comes from suffering and loss.
DP: Tell me about coming to the McGill International Congress on Palliative Care this October. We are certainly thrilled that you will be a plenary speaker.
SP: I am so honoured to be coming to speak at McGill. This is the oldest and one of the most revered forums and so when I got the invitation to speak, I really was quite blown away. I am really excited to come and share my thoughts as a writer and a doctor on the moment we are in, what I have seen during the pandemic as a palliative care doctor, and how our collective experiences as practitioners and human beings can be mined for their meaning moving forward. I think there is a lot of suffering to contend with but there are ways that we can find to light the path for ourselves and others moving forward. So, I am really excited and really honoured to be part of the conference, and a plenary speaker no less!
DP: We are certainly very honoured to have you. At our last congress, it was exciting to have participants from about 65 countries. How do your experience and thoughts translate to such a wide audience?
SP: What we have all gone through as a community of practitioners, but also just as people over the last few years, the experiences of suffering and grief and loss transcend languages, cultures, continents, all of that. I am very curious to hear from people from different parts of the world about how they experienced COVID and their work as palliative care practitioners in different settings because certainly in the US, it has an orientation that is very different than my home country of India. I am very curious to hear about what translates from what I have to say from what others have to say, into different contexts and also what I can learn from people who have had very different experiences. Palliative care gets at the most essential aspects of humanity – how you want to live, how you want to die, what life means to you, and I think those things that no matter where you live, what role you play, those things resonate with you as a human being. Our field is a practice of caring but also a practice of tending to the very things that make us human – mortality, suffering, living well, dying well, who we love, how we want to live when we have been through a calamity like this. I think it’s going to be fascinating conference and I am so excited to learn from everybody who attends.
Dr. Sunita Puri (@SunitaPuriMD) is the author of “That Good Night: Life and Medicine in the Eleventh Hour.” She recently published an essay entitled, We Must Learn to Look at Grief, Even When We Want to Run Away. She is an associate professor of medicine at the University of Southern California, where she has served as medical director of palliative medicine and chair of the ethics committee Dr Puri will be a plenary speaker at the McGill International Congress on Palliative Care, Oct 18-21, 2022.
This interview has been slightly edited for length and clarity.