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This Doctor Can: My journey into palliative medicine

Dr Sarah Cox, a consultant in palliative medicine, and chair of the RCP’s Joint Specialty Committee for Palliative Medicine, talks about her journey into palliative medicine and how she came to be one of the lead authors of our new end-of-life acute care resource.

I am a palliative medicine physician and proud co-author of the newly released RCP acute care resource in end-of-life care. This resource, created with colleagues in palliative medicine and a patient representative, is an opportunity to support our non-palliative medicine colleagues in the care of those at the end of their lives. I believe there is nothing more important than how we treat those who are dying, because after all, it will happen to all of us one day.

I’ve been a consultant now for more than 20 years, in the most privileged position of supporting patients at the ends of their lives.

Dr Sarah Cox

I fell into a job in a hospice after finishing a round of hospital SHO jobs. I had passed membership and enjoyed hospital medicine, but I couldn’t find a specialty that felt right. In the early 1990s there was very little training in palliative care, and no career path. I’d picked up a smattering of knowledge about the topic from the hospital palliative care nurses in my house surgeon job. I was left to look after a ward full of patients who had advanced cancers. These patients were post-op but remained ‘unfixed’ and were beyond the help of my lovely surgical consultant. The palliative care nurses were the only ones who had an inkling of what we could do to help these patients. 

So, unsure what it was all about and where it would lead, I went off to the hospice. After just a few months working there, I knew palliative medicine was for me. I had the time I needed to care for patients in the way I thought they deserved. In comparison with the pressures of a busy district general hospital medical SHO rotation, it felt like bliss. I have never regretted that decision. 

I’ve been a consultant now for more than 20 years, in the most privileged position of supporting patients at the ends of their lives. People allow me to be curious about their past and present, to share their fears, to help them redefine what hope might mean in the face of a future that is suddenly uncertain. I love learning what makes people tick (especially the challenging ones!) and I love the problem-solving that is required to achieve good symptom control. I love working with nurses and therapists and chaplains, and together making a difference to those facing a limited life.  ‘I don’t know how you do your job’ is something I regularly hear from patients and colleagues. I honestly can’t imagine doing anything else. 

Would you like to share your experience of going into medicine? Get in touch on Twitter via @thisdoctorcan.