By Dr Abdulaziz Alkhayyat

What is the worst that can happen—I die? That is a very normal thing!’ These were the courageous words of my late father, Dr. Ridha Alkhayyat, amidst the most harrowing moments of my life. Diagnosed with late-stage lung cancer at the height of the pandemic, while I was in medical school, frequent hospital visits became our new normal. Yet, in those moments, my father would often remind me of the ordinariness of death.

His perspective on mortality profoundly influenced my understanding of death and underscores the critical role of palliative care.” Palliative care is defined as holistic care of people with health-related suffering as a result of severe medical conditions, especially, but not only, those nearing the end of life (Radbruch et al., 2020). Its aim is to improve the quality of life of both patients and their families. Despite its importance, misconceptions and stigma often lead to its underutilization (Cherny, 2009).

To bridge this gap, my team at The Doctor’s Brew partnered with the Kuwait Association for the Care of Children in Hospital (KACCH) and Bayt Abdullah Children’s Hospice (BACCH), organizing the ‘TDB Cares: Palliative Care’ event in honor of my father Dr Ridha Alkhayyat. This initiative, through expert-led panels and lectures, highlighted palliative care practice in Kuwait, the vital work of KACCH & BACCH, and the role of junior doctors in palliative care.

Through this article, I aim to share the transformative insights from our event, hoping to challenge perceptions and encourage wider embrace of palliative care. In practice, palliative care is underutilized and misunderstood. For example, a study exploring deceased patients who had solid cancer tumors found that only 9.6 percent of patients received palliative care (Osagiede et al, 2018). Common myths about palliative care, including that it is “giving up” or that it is solely end-of-life care, hinders its utilization clinically (Cheng et al, 2019; Cherny, 2009).

Contrary to these myths, studies have shown that palliative care actually prolongs life (Temel et al, 2010; Hui and Bruera, 2016; Sullivan et al, 2019; Zhi and Smith, 2015). These issues are particularly pronounced in Kuwait, where not only is palliative care underutilized, but there is also a shortage of providers. This is illustrated by the common question posed to our team at The Doctor’s Brew regarding our event at Bayt Abdullah—’who is Abdullah and why are you hosting an event at his house (bayt)?’ So, what exactly is Bayt Abdullah? It is the Middle East’s sole children’s hospice, offering holistic palliative care support to children with life threatening illnesses.

These include counseling, clinical services, music therapy and more. Bayt Abdullah can only be described as a colorful oasis tucked away in Shuwaikh boasting a playground, library, and a ferris wheel designed by the same team responsible for the London Eye! Despite providing medical services such as taking blood and administering medication, BACCH does not feel like a hospital. Unlike traditional hospitals, it is adorned with color, the sound of children playing replaces the beeps of machines, and natural sunlight fills every room.

An extension of the KACCH, a non-profit, charitable organization, BACCH and KACCH together provide therapeutic services across nine government hospitals in Kuwait. It is critical for every doctor and healthcare provider to be aware of what KACCH and BACCH offer, ensuring children facing life-limiting illnesses can be referred to this exceptional facility. As victims of imposter syndrome, it is easy for young doctors, such as myself, to feel that our work is futile. However, as part of our training, we naturally have to spend more time on the wards and with patients than senior physicians.

With this much facetime with patients, it is preposterous to believe that we have no impact on their care. Recognizing this, The Doctor’s Brew emphasized the vital role of junior doctors in palliative care at our recent event. We highlighted two main strategies: effective communication and active advocacy. Open dialogue helps dismantle stigma. By employing communication models such as the SPIKES framework in delivering bad news and using active listening skills, patients and their families are more likely to be receptive to palliative services.

The goal is not to persuade, rather, it is to foster trust which plants seeds for future consideration of palliative interventions. Outside the hospital, however, there is still plenty to be done. By being an active advocate of palliative care in our personal lives, whether by volunteering at KACCH and BACCH or talking about palliative care values in social settings, we can cause a shift in misconceived societal viewpoints. Being a doctor, for better or for worse, extends beyond the hospital walls and we all have a choice with what to do with that title when we finish our workday.

My suggestion is to use it for the betterment of health, people, and society as a whole in whatever way that brings you joy and self-fulfillment. In closing, I would like to remind those of you reading who feel that palliative care does not apply to your life- think twice. Death is a universal right, fear, and paradox that humanity has confronted since the start of time. We all confront mortality whether it is our own or of those we love. Remember that palliative care is not only about the end of life, it is about the quality of life. Learn about palliative care today so our final chapters on earth can be ones of calm, peace, and love.