Gratitude and Grief

Last week I had the privilege to attend the Global Launch Symposium of the Lancet Commission Report, “Alleviating the Access Abyss in Palliative Care and Pain Relief”. Throughout the event I had the opportunity to connect with hospice and palliative care professionals, global health experts, and many others to learn more about the findings of this landmark report.  The purpose of the event was to develop action steps and design programs for national, regional, and global organizations to implement the key findings.

I listened to the presentation of findings and felt mixed emotions. Initially, I felt the grief associated with the inequity of palliative care and pain relief the world over. In particular, the fact that the majority of the poor in low and middle-income countries live and die in pain without the benefits we sometimes take for granted. 

The report explains how 61 million people worldwide experience serious health related suffering each year. Over 80% of them live in low and middle-income countries and lack the most basic access to pain medication and palliative care. Of those, 25.5 million died without the benefit of pain relief, among them children.

 One is forced to ask, “Why do the poor not have the same right to pain relief that those of us in high income countries expect?”  These issues were discussed during the symposium and the report (linked below) details both the problem and solutions.

In addition to grief, I also felt gratitude. 

Gratitude is often challenging to marshal when dealing with these difficult realities. However, it is something we need to consistently bear in mind. For in order to be the voice of the voiceless, we need to first reflect on our good fortune and privilege. Doing so can help us realize what we have and understand what not having it might represent.

Additionally, expressions of gratitude give others the strength they need to deal with the challenging work ahead. Starting from a place of gratitude, a “place” in fact, where I began my prepared remarks at the Symposium, can be powerful.

Think about the expertise we have available to us to provide expert pain and symptom control. As an example, access to medications and also the non-pharmacologic interventions that help our patients and families. Also, think about the many dedicated physicians, nurses, social workers, spiritual care providers, therapists, volunteers, and all others on our teams that we can thank. And then thank them!

So, let me say how grateful we are to all of you for the tremendous work you do every day. And again, tell a fellow team member how much you appreciate them too.  

For more about the Lancet Commission Report. 

By John Mastrojohn III, RN, MSN, MBA
Chief Operating Officer
NHPCO