I have recently written about my experiences that have led to my becoming a palliatrist, in a blog which is expected to be available for public dissemination soon. In it, I write about the gradual change in perspective and a new found respect, upon being given full responsibility of my patient. However, I have not… — read more

A review was recently sought for a patient with stage 3 Lung cancer, with history of recent receipt of immunotherapy, admitted with neutropenic sepsis in the medical ICU. I was told that the patient’s wife seemed unaware of the poor prognosis. I discussed with the admitting consultant whose resident outlined the situation to me thus,… — read more

Recently, I was asked to review a patient admitted in the NeuroICU, and the information conveyed to me was that the patient’s family had requested consideration of admission under palliative care. This was a setting ripe with a multitude of challenges – legal, ethical and moral and tinged with a newness – of entering a… — read more

In my third week in this position, today is the first day that I have reviewed four patients. The fact that the emphasis, while discussing goals and expectations, has been on the functional status is definitely a positive. Each of these reviews makes me think about the requirements of my role as a specialist. The… — read more

Pathogenesis of paraneoplastic itch has been recognized to be analogous to neuropathic pain involving peripheral and central sensitization, giving heft to the argument underlying the use of neuropathic pain modulators in this setting. The optimal sequencing of these agents is important while adopting a mechanistic approach. This blog post provides an insight into the identifying… — read more

Paper under discussionHaubner, A., Oluyase, A. O., & Higginson, I. J. (2026). Rapid Relief of Breathlessness With Fast-Acting Opioids and Benzodiazepines: A Systematic Review. Journal of pain and symptom management, S0885-3924(26)00756-6. Advance online publication. https://doi.org/10.1016/j.jpainsymman.2026.04.606 Having chanced across a recent systematic review on the utility of opioids in acute breathlessness by Haubner et al, I found… — read more

Among the causes of pain in this situation, where a diagnosis of recurrence has not yet being made with histopathological certainty, the following may warrant consideration – recurrent disease, neuropathic pain syndrome, pancreatitis in the remnant (trastuzumab related immune mediated – known but rare), visceral hypersensitivity and psychological distress. Interestingly, this situation characterized by the… — read more

What difference does telling patients explicitly that they are receiving placebos with no pharmacologically active ingredient have on their effect? What specific feature in the neurobiology of fatigue make it most suited to the use of OLPs for management? Does the absence of a single receptor- peripheral lesion make it particularly suited to OLP use,… — read more

Lymphedema is known to be a common precipitant for cellulitis where pain severity can become disproportionate. The formulary clearly lays emphasis on the role of good analgesia including use of opioids in the management of pain related with cellulitis. In addition to the careful use of opioids, following measures are advised: Bed rest and elevation… — read more

Paper under discussion: Crooks J, Simpson-Greene C, Hughes L, et al Exploring barriers to and experiences of palliative and end-of-life care for people living with HIV: a cross-sectional surveyBMJOpen 2026;16:e107980. doi: 10.1136/bmjopen-2025-107980 Background WHO recognizes Palliative care as an essential part of the HIV disease trajectory. HIV has been listed as a condition where access to palliative care has been historically marred by… — read more