Profile of a Palliative Care Pioneer

Volume 23, Number 3: March 2022

Moved by the Spirit: Dr. Douglas Bridge on the remarkable gift of death

Dr. Douglas Bridge. Photo supplied by Dr. Bridge. Used with permission.

By Alison Ramsey
IAHPC Newsletter Editor

Douglas Bridge’s intellectual desires and humanitarianism led him along two paths, theology and medicine, that brought him to a single place: palliative care. He is among the early cohort of physicians who nourished the growth of palliative care in Australia and beyond. As Dr. Bridge views it now, at age 75, he was helped along the way by physical trials and soul-shaking blows that honed his spirituality, which became his particular career focus. Today, the Parkinson’s disease that he was diagnosed with 14 years ago has given him fresh perspectives on his life, work, and death.

The best way to report on our conversation is a hybrid of story and Q&A.

What was your reaction to the Parkinson’s diagnosis?

“I was very distressed. I thought: ‘I’m the Head of a department, very successful, and have a farmhouse on 500 acres of land. I can’t do that now!’

“If we have a good education, employment, are able to travel and have good health, it’s a superficial, easy life. If we’re not blessed by disastrous suffering, we drift on until we face real death. In some way, the dying process is a divine gift for us, the last opportunity for us to wake up.”

You have been forced to slow considerably, after a lifetime of great activity. What has that been like for you?

How PC should be taught

“Palliative care providers, as a whole, are more spiritual than most people—it attracts people who are sympathetic to that aspect.

“We should never compel people to do palliative care, and we should learn palliative care by apprenticeship—not by lectures: by working alongside a master.”

“It has taken me two years to wean myself off my addiction to the treadmill of work, work, work. The transition from ‘internationally acclaimed professor’ to ‘mumbling, stumbling geriatric patient’ was more painful than I expected.

“Some days I’ve been overcome by grief and fear. At other times I have felt securely enveloped in a cocoon of love and safety… I am practicing a policy of seeing every event as a gift, including the gift of Parkinson’s disease and the gift of dying.

“I’ve let go of my medical practice, but am still teaching the spiritual dimension of palliative care.”

Parkinson’s disease wasn’t the first diagnosis to shape your life. Or even the second.

“I had bronchial infections throughout my childhood and, as a 19-year-old medical student, was diagnosed with bronchiectasis. I looked it up in my pathology textbook and read, ‘childhood bronchiectatics rarely live beyond the age of 40.’ I thought, “Not many years to go, mate. Not many years to go.” I was shy, and didn’t tell anyone. It took me a long time to accept myself. It also pushed me to get things done, to not fail. Now, I’m 35 years past my use-by date. Which taught me another lesson: be cautious giving a prognosis!”

Yet worse was to come.

One of his early “difficult” patients

“I was called to see a patient with cancer in his spine, who was receiving 20 ampoules of morphine, 600 mg total, intravenously in one hour! But the man was asking for more pain relief. I was stumped.

“Now, straight away I would diagnose opioid-induced hyperalgesia and switch to methadone. But we didn’t know that yet. We stumbled on in our ignorance, without textbooks, journals, or training courses.”

Driven to help those in great need, Dr. Bridge chose to practice medicine in badly underserved Bangladesh, where he lived for two years in a village. Repeated lung infections forced him home to Australia, where he was appointed a consultant position in Fremantle Hospital In 1980. In 1983 he agreed to provide hospital backup to a new home care program initiated by Dr. Douglas MacAdam.

“He (MacAdam) needed someone who could talk about death. I think I saw palliative care as an alternative to my medical mission in Bangladesh. It was a substitute to working with people in desperate need.

“It seems fantastic [as in, unbelievable] now, but back then doctors said, ‘How can you justify all these expensive resources for just a few privileged patients?

Then illness struck Dr. Bridge again, in 1998. He was nauseated, couldn’t eat, and his weight plummeted. “For the first time, I thought I could be dying.” A battery of tests turned up a parasite and stomach ulcer, both of which were cured within a week of treatment.

This time it was the illness itself, not its diagnosis, that changed your life.

“Finally, I didn’t feel sick anymore! I could return to my normal life. But I didn’t. The change in me was profound. I viewed life completely differently. In my office at Royal Perth Hospital I noticed a huge pile of trainees’ research papers. ‘This is rubbish,’ I thought. ‘When I die, no one will want to read these. If it’s not important to my successors, I’ll throw it out now.’ In my new way of looking, almost nothing was important. That’s when I shifted to spiritual care, something that is grossly underdone still.”

Next month: More of Dr. Bridge’s life’s work and personal journey on spirituality in palliative care, and the immense value of a plastic pig.

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