The Sanctuary of Twilight

The Moral Imperative

As a physician, my entire life had been dedicated to the fight. We are trained to view death as the enemy, a failure of our science, a battle lost. But my years as Medical Superintendent taught me a harder truth: there is a profound difference between extending a life and merely prolonging a death.

By 2018, I had just finished the monumental task of building our new library. I was looking forward to a period of administrative calm—a chance to breathe. But destiny, in the form of the institute’s management, had other plans. I was asked to construct a dedicated Palliative Care Centre.

I hesitated. My career was built on the pillars of Internal Medicine—curing the curable. Palliative care, the art of comforting those we cannot save, was a landscape of shadows I had not yet navigated. But as I walked the wards and saw patients with end-stage cancer tethered to machines, their eyes a well of pain and abandonment, my hesitation vanished. This wasn’t just a construction project; it was a moral imperative.

The Architects of Compassion

A dream of this magnitude requires more than just empathy; it requires capital. We found our “Architect of Compassion” in Mr. Ramu S. Deora, who stepped forward to donate approximately ₹5 crore in memory of his father, Mr. Sitaram Deora.

The catalyst was our trustee, Ms. Sarla Parekh. A force of nature with an abiding love for Sevagram, she had already funded our Medicine Department building. Her credibility was the bridge that brought Mr. Deora to our cause. With the funding secured, I dove into the blueprints. We collaborated with Mr. Ramteke, our architect, but as often happens in Sevagram, we eventually placed our trust in our own in-house engineering team. Mr. Harshal Deoda, with whom I enjoyed a long assocaiton in several buildings, and our contractor, Mr. K.P. Bardhiya, to turn drawings into reality.

The Pandemic Pivot

We broke ground in June 2019. For months, the rhythmic grinding of mixers was the heartbeat of the campus. Then, in March 2020, the world stopped. The COVID-19 pandemic swept across India, bringing a suffocating silence. The skeleton of our building stood naked against the summer sky, a stark reminder of the uncertainty gripping us all.

When we finally resumed work in May 2020 under strict protocols, my perspective had shifted. The isolation of the lockdown made me acutely aware of the loneliness of the sick. I began to worry: would patients feel exiled in this new building, so far from the main hospital bustle?

That anxiety birthed a new idea. I decided to expand. We added a second floor for the Radiation Oncology department. By housing both specialties under one roof, we created a seamless ecosystem for cancer care. I also insisted on six private rooms. In a Gandhian institution, we prioritize the poor, but I knew that dignity often requires privacy, and providing options for every financial stratum was essential to our ethos.

Designing for the Soul

I was adamant about one thing: this building must not smell or feel like a hospital. We chose a “Rose Gold” color scheme for the interiors. It wasn’t just an aesthetic choice; rose gold radiates a warmth that softens the clinical coldness of medical equipment. We coordinated the walls, the curtains, and even the foldable couches for caregivers to match this palette.

To anchor the spirit of the center, we commissioned a mural for the wall behind the registration desk. It is simple but moving: a young doctor’s hand gently holding an old, withered hand. It is a promise of presence.

Outside, a miracle was taking place. I enlisted Mr. Harshal Deora, a brilliant engineer from our team, to transform the surrounding debris-strewn land. Harshal and our gardener sculpted a “step garden” filled with Tacoma, Oleander, and Bougainvillea.

In a stroke of typical Sevagram frugality, the gardener repurposed old, discarded surgical ceramic washbasins as planters. He filled these medical relics with vibrant orange and yellow flowers. Now, patients aren’t greeted by concrete, but by the soothing whisper of Frangipani and Royal Palms.

Navigating Thorns

The journey was not without its thorns. We locked horns with town planners over fire exits, eventually designing a specialized emergency staircase to transport bedridden patients safely. There was also a delicate negotiation with Mr. Deora. In his enthusiasm, he wanted his name on all four sides of the building. I had to gently explain that such an ostentatious display clashed with the simplicity of Sevagram. We compromised, placing the name prominently only on the front facade.

However, the hardest battle was with my own fraternity. Doctors are trained to fight until the last heartbeat; to many, palliative care felt like an admission of defeat. I spent hours pleading with faculty members to move terminal patients out of the noisy, terrifying ICU and into the peace of the new center. To make it more welcoming, we piped in soft music and created a meditation room for families struggling with grief.

A Sanctuary Completed

On December 21, 2020, the doors finally opened. To ensure the legacy of this work, I asked my residents, Navaneeth and Fannie, to focus their MD theses on the problems of palliative caregivers. Under the mentorship of Dr. Preetam Salunkhe, they learned that medicine is as much about listening as it is about prescribing.

On that inauguration day, I sent an email to the entire faculty. I wanted them to understand that we weren’t just opening a ward; we were opening a sanctuary.

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From: Dr. SP Kalantri

Date: December 21, 2020

Subject: Inauguration of the Palliative Care Center and Radiation Oncology Department

Dear all,

I am pleased to announce that the construction and equipping of the Palliative Care Center and Radiation Oncology department on our campus have been completed. The building is situated 100 metres ahead of the Maternal and Child Health building and provides a picturesque view of the current Corona block.

It is a two-story building, with the ground floor comprising a registration counter, a 30-bed palliative care ward (including a few private rooms), and a small café for patient relatives to enjoy their home-cooked meals. The first floor features two palliative care OPDs, four radiation oncology OPDs, a registration and billing counter, as well as rooms for social workers and counsellors. Additionally, there is a 30-bed radiation therapy ward on this floor. The building is solar-driven and has a small garden, which provides a serene environment for both patients and caregivers.

The aim of this initiative is to provide dignified care to individuals struggling with chronic incurable diseases, and to show them that they can spend the later stages of their lives with minimal pain, misery, and agony. We hope to demystify death and ensure that caregivers and patients alike accept death as a natural part of life, and do not die alone in ICUs, surrounded by machines and strangers with tubes in all body orifices. Our goal is to promote emotional, psychological, and spiritual well-being in patients, and help them realize that they are not abandoned by their doctors, but are actively being helped.

It is undeniable that almost all cancer patients require palliative care, and it is important to introduce the palliative care team right from the beginning of the diagnosis, rather than at the end, so that they can work seamlessly with specialists to provide comprehensive care to patients. In addition, individuals with chronic incurable neurological problems, chronic heart failure, chronic liver disease, COPD, and chronic kidney disease also require palliative care. Patients struggling with cancer-related pain also benefit from palliation.

Operational Plan:

Dr. Preetam Salunkhe, assistant professor of medicine, will be the primary physician in charge of the centre. She will hold OPDs three times a week—on Monday, Wednesday, and Friday—and will also oversee all palliative care patients. She will work closely with the radiation oncology department to bring palliative care to their patients.

All departments are requested to admit or transfer patients who require palliative care exclusively. These patients will continue to stay in their units and will be rounded on a daily basis by their parent department and the palliative care centre. We encourage departments to collaborate and break down narrow silos to provide a more humane and comfortable care for patients. We will be happy to support the primary departments in this task.

We seek support from the departments of medicine, radiotherapy, surgery, ENT, ophthalmology, orthopaedics, neurosurgery, paediatrics, psychiatry, radiology, and obstetrics and gynaecology for this initiative. Without your active participation, MGIMS will not be able to run this centre.

If you have any questions, please do not hesitate to contact us. We will be happy to address your concerns.

Best regards,

SP

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