A general practitioner (GP) for the last 35 years, he has also run the Palliative Care Unit at the Dr. L. A. Miller Centre since the 1980s and taught many medical students over the years about communications and clinical skills related to palliative care.
Known for his sense of humour, caring approach and deep commitment to palliative care, Dr. Eaton too has had close personal experience with terminal illness.
He not only cared for his mother-in-law during the last weeks of her life, but recently cared for his wife, Norma, from their home, during the final stages of her terminal illness.
He is currently on sabbatical leave to continue studies in academic medicine and seems to be honing his sense of humour at the same time. As he says, “when I went on sabbatical, I took up ice skating – well last week I took up ice skating. And then I took up badminton – two things I haven’t done for 35 years – and it shows.”
I recently had an opportunity to speak with Dr. Eaton about his award and achievements. Below is a snapshot of our inspiring, enlightening discussion.
What inspired you to work in palliative care?
I read the book ‘On Death and Dying’ by Elisabeth Kubler Ross when I was in medical school and I found what she was saying really appealed to my sense of helping people. I was interested in making sure that people who were going to die, were comfortable. There were no palliative care services in Canada at that time, so I guess in a sense I predate structured palliative care here.
I’ve found over the years that being able to make people comfortable is professionally satisfying for me. As a GP for 35 years it was a natural fit – you try and comfort people through the various tribulations of life, which includes death.
What do you think about the recent Supreme Court decision to allow physician-assisted suicide in Canada?
I was involved in an ethical debate a few months ago that asked ‘should euthanasia be legalized?’
As a palliative care doctor, my view has always been against euthanasia, however I was asked to participate in the debate from a pro-euthanasia perspective. As a result, I did some research and what I discovered ended up changing my view. It’s the kind of thing that I would like the option for myself if I had a terminal illness and was near the end of my life.
What is the most significant change you’ve seen in palliative care in the last 35 years?
From my view, the most important change is the increased comfort level among mainstream doctors around the use of morphine for pain control in palliative care. Back in the old days when I trained, we were told that 10 milligrams (mg) of morphine was the most we could ever give a patient. That was the prevailing medical wisdom.
Today, we have people walking around taking much higher doses than 10 mg. Some people have a lot of pain – a lot of pain. Imagine all the bones in your back have been filled up with cancer. Imagine the worst back pain you’ve ever had; only now you have 14 spots on your back all equally painful. We start with five or 10 mg and the patient works their way up as their illness progresses and their pain levels increase.
We owe it to our patients, who are essentially at the end of their lives, to keep them as comfortable as possible for as long as we can.
The other important change is that the palliative approach has improved in the acute care setting. More doctors are saying to families and patients that, in certain cases, there is not much more that can be done and that making the person as comfortable as possible is best for them.
What do you think people should know about palliative care?
The reality is, when you have a terminal disease, you are only going to live for a certain length of time. If you opt for palliative care, it’s my belief you’ll likely live the same length of time as if you opt for aggressive care, especially in the case of cancers, in particular those that have progressed beyond a certain point.
My advice to anyone facing a terminal illness is try to figure out how long you’re likely to live and decide what you want to do with that time. Live the remainder of your life as best you can.
I also feel the patient needs to be better enabled to choose to live out their remaining days in comfort, rather than in hospital caught in a test cycle. I think a lot of people are ruled during the last part of their lives by hospitals and tests.
Once a patient decides they are ready for palliative care, they’re generally free from the hospital, free from tests.
Even then, it’s important to realize that being palliative does not necessarily mean you’ll spend your remaining days in a palliative care facility. You may be admitted and discharged as needed. Sometimes people may come in, get comfortable – meaning an adjustment in pain management, then go home and return when they needed further help.
And if you want to die at home, there are services that can help you. Accept help from friends, family and volunteers. Take advantage of some of the home services offered by the palliative care department such as home visits by health care staff, assistance with equipment and other supplies, and respite for caregivers.
When my grandmother died at home, my aunt said ‘we need to get nurses.’ When we got the nurses, my aunt said, ‘boy, we should have had them last week.’ People are reluctant to ask for the care, but once they get the care, most people are quite satisfied with it. We encourage people to come to us.
Do you think what you’ve taught medical students over the years around palliative care has made a difference in how physicians deliver palliative care services in this province?
I’m sure it has. There’s a whole bunch of palliative care champions all over the province that I’ve taught, but I can’t take credit. If they’re doing well, they did it on their own, I just happened to be there while they were learning.
I am a mentor to lots of family doctors who do palliative care as part of their practice.
While we do provide a palliative care service now, some family doctors also provide palliative care as part of their service. I also consult with GPs around palliative care and would really like to work more with family doctors and community care nurses.
People say, “I have to go to the hospital because I can’t be looked after at home.” We’d like to be able to change that so that everyone who wants this service, can have it.
What does winning the Palliative Care Local Hero Award mean to you?
I thought heroes jumped in front of busses to save six year old twin girls! When I looked up hero, part of the definition said a knowledgeable, good person. Well, I’m a knowledgeable, passionate person when it comes to palliative care and, hopefully, I’ve made a positive difference in people’s lives. ■
Palliative care has become an integral part of our overall approach to health care and is provided by interdisciplinary teams of professionals in our communities, hospitals, long-term care facilities and designated palliative care units. The aim of palliative care is twofold: to relieve suffering and to improve the quality of living of all people who have a life-limiting condition.
We salute all of our colleagues in palliative care services for their commitment to providing quality and compassionate care.
This story was written by Robyn Lush, communications specialist with Eastern Health