Many people believe that palliative care begins when medicine has run out of ideas, and they are right. But they are also wrong, and wrong very significantly, because of the unspoken assumption that goes with this belief. That assumption is that all that remains to be done is to keep the patient comfortable, usually by giving morphine for pain relief. It is hard to think of a less accurate description of the field. It’s also a bitter irony, because it offers a medical “solution” at precisely the point medicine has run out of solutions.

Yes, palliative care includes managing the patient’s comfort in their final days. But that is perhaps the smallest part of the enormous amount left to do.

As a young doctor at Charing Cross Hospital in London, I spent three months on a radiotherapy ward under the supervision of Dr. Mike, an exceptional senior registrar who had already completed his specialist training and was taking the final step toward becoming a consultant. Like many young doctors (and, unfortunately, some experienced ones), I assumed that success in medicine meant curing disease, and no more. Quietly, and without ever saying so directly, he dismantled that belief. He taught us the science of symptom control: pain, shortness of breath, nausea, constipation, anxiety, and the countless indignities that serious illness inflicts on body and mind. But he also taught us something more important. Knowledge matters, but compassion matters just as much. One without the other is never enough.

Halfway through my rotation, before we had properly absorbed this, Mike announced that he had accepted a consultant appointment in Oxford. I expected him to be heading a prestigious oncology department, as did Satya, my fellow house officer. Instead, he was going to lead a hospice. At the age of 25, I thought he was retreating from the........

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