“I remember all of my cases – they are recorded in my ‘Book of Life’!” jokes Paul Bashyam, HCA Medical Social Worker. He thumbs through a small, nifty notebook, filled with hand-drawn genograms and extensive notes about each patient under his care.
The detailed notes speak of Paul’s care and compassion for all of his patients, each with a different circumstance, hopes and struggles. It has been said that social work is a vocation of heart – for Paul, it began somewhat unexpectedly with a previous stint as a Police Coast Guard.
Besides border patrol to ensure national security, the job scope of the Police Coast Guard division also includes investigating and removing floating objects in the waters. Therein lies a tragic twist – sometimes these floating objects are decomposing bodies, usually a result of accidental drownings or victims of failed trafficking.
On other occasions, Paul had also encountered suicide cases in cars. Behind each case is a complex web of sorrow and loss – and it was the impetus to actively reach out and help others that inspired Paul to explore social work.
Exploring the notion of meaning with patients is an important aspect of the work that HCA’s Medical Social Workers do. “It is about helping patients to find meaning and purpose in their journey,” Paul says.
When the end of life looms near, the drive to find meaning often becomes stronger. This sense of meaning can come from different aspects of life, be it family or personal pursuits. For late HCA patient Abu Samah Bin Mohamed, making music and spending time with his loved ones meant the world to him.
It was Abu Samah’s last birthday, a momentous occasion Paul made much effort to plan for.
Paul, who was in charge of his case, understood the personal significance of these for Abu Samah. To bring his last wishes to fruition, Paul meticulously planned for them. From making a simple video recording of his favourite song, “Reflections of My Life”, to getting his feet wet for the last time in the sea and celebrating his last birthday at the hospital with his family, each of these wishes brought Abu Samah much comfort before he eventually passed on peacefully in March 2019.
Hospice care is as much about the family as it is about the patient. Facing the prospect of losing a loved one is never easy, no matter how much one tries to mentally prepare for the inevitable.
For Abu Samah’s wife, it had been difficult for her to accept her husband’s diagnosis of terminal cancer. It came as a shock to the family as there had been no indicative signs, before the cancer progressed to an advanced stage.
Abu Samah’s devoted wife continued to lavish meticulous care upon him, preparing his favourite meals and accompanying him for medical appointments.
Abu Samah and his wife, who devoted herself to caring for him after he fell ill.
The transition from being a full-time caregiver to days with ample pockets of free time can be disconcerting for bereaved loved ones. “We usually visit bereaved families for one to two months after the patient has passed on,” Paul explains. “We ask how they are coping with the loss and also observe for any worrying changes in behaviour. We will refer them to other organisations for follow-up if needed.”
What is it like, facing death and dying on a daily basis? “The heart gets tired, which is why it is important to destress,” Paul says. “I play the guitar and also jog from time to time. Having some quiet time to process my emotions is important.”
The greatest rewards of the job lie in the heart as well. “We often have the opportunity to form deeper connections with our patients and work through psychosocial issues together.”
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