Opening new doors to Palliative Care

Images of open doors hold special meaning for Dr. Phillip Cooper, who recently started a new role as palliative care physician in south western Nova Scotia. Framed photos of ancient stone entranceways on his office wall at Yarmouth Regional Hospital are a reminder that we are all on a journey, including those who are nearing end-of-life and their families.

“We are fellow travellers. We all have stories to tell, and telling stories is a big part of what we do,” said Dr. Cooper, describing one facet of his approach to providing palliative care. “I always make an attempt to engage with the patient as a person and the family on a human level before I try to intervene on a clinical level.”

Dr. Cooper feels it is important to meet people where they live to foster relationships with patients and families receiving palliative care. 

“Most of my work is actually in the community, and not institutions,” he said. “Many patients will be in their own homes when we first meet.”

It is important for patients and families to have the support needed to make their own choices about palliative care. Dr. Cooper speaks proudly of the increase in the number of patients and families deciding to receive palliative and end-of-life care in their homes during his time working in Nova Scotia Health’s Eastern Zone.

By working closely within the community, he sees opportunities to broaden how people view palliative and hospice care. 

“I have always seen it as part of my work to do public engagement with seniors groups, church groups, long-term care providers, and to try to correct common misconceptions about what palliative care is and what it is not,” said Dr. Cooper. “Although most people believe that palliative care is the same as end-of-life care, it is not hard to explain that what we actually do is focus on living and not only on dying.”

For Dr. Cooper, the journey to becoming a palliative care physician-led him through plenty of doorways in his career, from practicing medicine in developing countries to a move to Canada in the 1980s and working in Manitoba “…as an old-fashioned all-around country doctor.” 

He then relocated to Digby, Nova Scotia during which time he met his future wife Simone from the Acadian community of Clare. The pair moved to Antigonish in 1995 when Dr. Cooper accepted a position at St. Martha’s Hospital. Along with his surgical practice, Dr. Cooper began a medical oncology position and later took on further responsibilities in palliative care. He describes doing all three jobs – surgery, oncology and palliative care – as hectic, but it helped him realize his true professional passion was palliative care.

“I looked back and discovered surgery was what I did, but a palliative care physician is who I am.”

Over the years, Dr. Cooper often returned to his wife’s home community to provide training sessions for palliative care volunteers. He saw the chance to move back to the area for a full-time palliative care position in south-west Nova Scotia as an “…exciting opportunity to help develop a sustainable palliative care program for the tri-county region (Digby, Shelburne, and Yarmouth) over the next several years, while for Simone it will mean living near her family and Acadian roots in Clare.”

He is now able to draw upon his experiences in surgery and oncology to help inform his palliative care practice. 

“In the last 15 years it has become established in cancer care that people who have early integration of palliative care in their cancer treatments live longer, live better quality lives and the care they receive costs a lot less,” said Dr. Cooper, adding that instead of just treating the disease, palliative care treats the whole person and their family. “It is very much more than just pain and symptom control or end-of-life care. That is only scratching the surface of what people actually need at this stage in their lives.”

Getting settled as the new full-time palliative care physician in southwest Nova Scotia has not only opened a new door for Dr. Cooper and his wife Simone but also for the patients, families, and other members of the palliative care team. In light of these new opportunities, Dr. Cooper contemplates the photos of stone doorways on his office wall and gifts from a friend whom he helped through his final palliative journey.

“I just love the symbolism of open doors. Where are they leading? You may not be able to see where we are going to go when we pass through these doors, but they are surely taking us somewhere. Leading us to places we may not yet know.”