Death and caring for the dying are thought of as taboo topics. But the pandemic - which has led to people dying alone in hospitals across the world - has, in a way, highlighted the importance of palliative care.
"Within hospitals, both in Singapore and overseas, people are isolated and dying alone. Palliative care services are much more involved in the care of such patients, including those within the intensive care unit," says Dr Cynthia Goh, 71, chairman of Asia Pacific Hospice Palliative Care Network.
Palliative care workers have chipped in to help with tasks such as Covid-19 test swabbing or looking after Covid-19 patients.
Hospices and hospice home-care services have seen more referrals as terminally ill patients leave the hospital to make room in wards for Covid-19 patients.
"The hospice services felt they were contributing to the national effort in battling the pandemic, and no palliative care patients were neglected," she adds.
Dr Goh, a senior consultant at National Cancer Centre Singapore's Division of Supportive and Palliative Care, says palliative care is not only about caring for the dying.
Such care, she adds, often starts when a serious illness such as advanced cancer or advanced heart disease is diagnosed.
It also covers how the patient and the family are coping, and whether they need social, caregiving, financial or other support.
"If all is well and the disease and the symptoms come under control, palliative care may not be needed again, or not unless the disease comes back and gives trouble. So, it's not just about caring for people near the end of their lives, but sometimes, years before the end."
To raise awareness of palliative care, the Asia Pacific Hospice Palliative Care Network has collaborated with literary non-profit organisation SingLit Station to launch an anthology of poems.
The book is a collection of 111 poems on life and death featuring not just Singapore poets such as Alvin Pang and Stephanie Chan, but also healthcare workers, students, caregivers, doctors and patients from across the Asia-Pacific who have never written poetry before.
Its title, To Let The Light In, is taken from a line in Hospice Zen, a poem by Indian poet Amlanjyoti Goswami.
The anthology's co-editor Zaris Azira says: "We chose this line because we wanted this collection to be a source of light, comfort, shared grief and emotional connection for everyone involved in the palliative care journey."
The book was launched last month on fund-raising platform giving.sg with the aim of raising $30,000 by next Tuesday; and to distribute 1,000 copies in total to patients and healthcare workers from Ren Ci Community Hospital, Tan Tock Seng Hospital, Singapore General Hospital and HCA Hospice Care, among others.
Dr Goh says: "Expressed in poetry, we are able to savour to the full the myriad of feelings that we and others have had, often brushed aside in the busyness of life. We can see more clearly what it is all like - the many facets of human experience."
Poetry as a coping mechanism for grief
Writing has helped Dr Jamie Zhou to appreciate her work as a palliative care doctor and cope with challenges.
"In palliative care, we dive to the deepest end to explore both the suffering and the beauty of life. The witnessed suffering might get too much sometimes, so writing is like coming up before your tank gets empty. It helps me process what I witness and experience," she says.
The poem she wrote for the book, To Let The Light In, tells the story of one of her patients, a young mother dying of breast cancer.
The patient was diagnosed while she was pregnant. For the sake of her baby, she underwent chemotherapy only after she delivered.
However, it was too late by then, as her liver was overwhelmed by cancer and she became deeply jaundiced. She died, leaving behind her husband, parents and five children.
Witnessing this was hard for all involved, including Dr Zhou, 39, a consultant at the National Cancer Centre Singapore's Division of Supportive and Palliative Care.
"The poem was written to process the difficult feelings I had and to this date, I haven't been able to find a title to name her painful story.
"I remember crying after writing the poem, but feeling a release after putting it into some words," she says.
While dealing with grief through writing is a safe "mechanism" for Dr Zhou, she notes that each person copes in his or her own way.
This can be through getting support from one's friends or seeking professional help.
She takes comfort in the fact that the heart that grieves is the same one that loves and endures.
"Over time, we learn to live with our grief, but it never really goes away. Chances are, between the surges of intense grief, you will have time to live and function, until the void becomes a part of your life," she says.
To Let The Light In: A selection of poems
Dr Jamie Zhou
The breast that was supposed to nourish,
Turned against mother and child.
Chemotherapy unleashed, but alas,
Sweet milk turned to bitter gall.
To My Grieving Friend
Delora Sales Simbajon
Let me walk
the span of your
sorrow. Tell me
of kites you've raised
but have not flown.
Speak to me
of your brother's last
in the closet. Let me
hear how you measured
his medicines in doses
of hope until that final
stroke of midnight.
But I can also stay
weighing this silence.
Cheong Lee San
whose heart beats harder?
your drug-spiked one
or mine brimming with pain?
your hair has fallen in clumps
your cheeks are sunken, pale.
yet you have strength for a smile.
outside the ward windows
two sparrows fly by, chirping.
oh, how we long to be free too.
Crossing The Street
Dr Alfredo Chua
No one knows.
When? Where? How?
Probably when I go to sleep later
Or when I walk to work tomorrow
Or while crossing the street going home.
Patients usually ask, "Until when?"
"How many months?"
"Will it hurt?"
No one knows.
If we have the answer, will it matter?
Will we live differently?
Will we cross the street more carefully?
No one knows.
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