For twenty years I have been working to assist patients in the advanced phase of illness and in the final phase of life. Palliative care is, in fact, the branch of medicine that looks after so-called incurable patients for whom — there being no longer any room for recovery — there is still a great deal to be done in terms of care. Thus, palliative medicine starts from the premise of having relinquished the healing power of modern medicine. Much of the history of medicine is made up of men who could do little in the face of the natural progression of disease: it is only in the last century that the discovery of drugs and the development of technologies led medicine to remove death from its horizon, confusing the care of the sick person with the treatment of the disease, and causing a certain kind of medicine to look away from the failure represented by the patient who dies.

The doctor on the same level as the patient

Palliative medicine greatly diminishes the role of the doctor, reducing the — sometimes dangerous — asymmetry that arises in the care relationship, and brings the doctor back onto the same level as the patient: both are confronted with the mysterious experience of death. When I say doctor, I am extending the concept to the other healthcare figures who are necessarily involved, because care for the dying is team work par excellence.

In this way the doctor makes available their technical skills but above all their human ones, in the awareness of being faced with the mystery — regardless of whether one's perspective is secular or religious — that the end of life represents: they take off the white coat and return to being a man or a woman who has the privilege of accompanying another man or another woman along a unique and unrepeatable stretch of their existence.

Everyone should prepare for the journey from life in their own way

If it is true that each of us chooses to pack our bags in different ways and at different times when we have to set off on a journey (and some people prefer to have others pack for them), then I like to think that for the journey par excellence that is death, each person must and can prepare in their own way. For this reason there are no standard treatments at the end of life: dying is not a disease, but an existential event, and death is part of the path of the unique and unrepeatable individual, at whatever moment in each person's story it takes place. The history and uniqueness of the individual should find space at the end of life.