Offering comfort, not cure: the palliative care specialist

“Contrary to what people may think, working in a hospice doesn’t mean we all go around with long faces. We’re serious when we need to be serious, but there’s a lot of laughter and fun from patients, their families, and the staff,” says associate specialist Alison Phippen. “It’s not a grim place, there’s a lot of normal life going on,”

The specialist in palliative care at St Ann’s Hospice, Manchester, was drawn to her career when she was helped by a Macmillan nurse as a junior doctor. “I was so impressed by her. There weren’t many Macmillan nurses around back then but she knew exactly what to do and what to say to a young patient who was having seizures from their secondary malignancy,” Phippen says. “We also had staff come in from a local hospice to help people with intractable symptoms and so I decided to work for six months at St Peter’s Hospice in Bristol. I loved it and certainly found my niche.”

Early in her career Phippen realised that medicine wasn’t always about making people better. “You cure occasionally and comfort always, as the old saying goes. It’s really about your own philosophy—we will all die, that’s a fact, but it’s an area some people shy away from.”

“What makes it attractive to me, is to do it well,” she adds. “We work quite intensely with patients and their families at a difficult time of their lives, but we can make a difference. That’s real job satisfaction—you can’t change what is going on biologically, but you can make a great deal of difference to symptoms and to help people get their heads around what’s going on. It’s really rewarding.”

She says that it isn’t a job for everyone and that younger doctors who are interested need to try it out and see whether palliative care is the right role for them. “You have to think about the long term. If you’re going to drain yourself emotionally doing the job, then you’re probably not going to be able to do it for 20 to 30 years,” she explains. “You have to make sure you have other interests and distractions in life to help you cope —for me it’s family, walking the dog, and baking, often for colleagues, that help to distract me and take my mind off work.”

Phippen says that her biggest personal challenge is hearing loss. “I lost quite a bit of my hearing 10 to 15 years ago. I’m used to wearing hearing aids, but it’s difficult for me because a lot of our job is about listening to people and listening is hard work—especially if I have patients who speak softly because they are very tired or they have neurological conditions. But my colleagues are supportive and are used to me asking if they caught what the patient said.”

She adds that she is at an age when she has started thinking ahead towards retirement. “The older you get, the more you want to be training up the people who will take over as you move on. That feels increasingly important to me. People say, ‘Didn’t you want to be a consultant?’ But I didn’t—my role has been much more satisfying. It’s about being with patients as they deal with a very difficult time. If I look back at my career, I might have said to my younger self, ‘Be a bit kinder to yourself, don’t try to be superwoman.’ But I’ve absolutely no regrets.”