Dr. G. Lesley Reece is a palliative care physician, advocate, and educator in Barbados. Her TikTok videos have become a sensation, garnering over 14,000 followers. Earlier this year, End of Life Choices New York partnered with Dr. Reece to create a TikTok video about palliative care. To date, the video has been viewed over 5,000 times across all social media platforms. We caught up with Dr. Reece to learn more about her work and palliative care in the Caribbean. Check out the interview below.
Quite interestingly I didn’t choose palliative care. I like to say it chose me. I worked as a concierge family doctor, seeing patients at home and my patient demographic became more of those who are elderly or who had longstanding problems which prevented them from attending office visits. One of my colleagues, after receiving feedback from patients he would have referred to me, suggested that I may be well suited to palliative care. There was also a palliative care conference approaching and he urged me to go. I attended it, and it was at that conference that I had my “Aha!” moment. I realized that I had been using the palliative care approach with many of my patients, and I immediately fell in love with the specialty, based on the tenets of holistic alleviation of suffering.
I love seeing my patients and their loved ones become visibly more relaxed after the first consultation. When we first meet, many times the anxiety and worry is almost palpable in the room, but by the end it has usually been replaced by a sense of calm as they realize that they are not alone in their journey and that I (along with the other members of the palliative care team) am there to help them navigate whatever may crop up.
The goals of the BAPC are to make quality palliative care accessible to all persons within Barbados who may need it. In Barbados, we have free public health care, but palliative care to date has not been included in the public health care framework, so has to be covered out of pocket. There are therefore patients who need it, but may not be able to afford it and/or don’t have medical insurance to help cover costs. The BAPC then helps to provide care through nursing, medical, counseling, bereavement and other services, either at a subsidized rate, or in some cases, we cover the costs.
Palliative care may look very different from island to island, but I can speak to the Barbados setting, and to a lesser extent Jamaica, as I did some of my palliative care training there. In Barbados palliative care is provided in a community setting, with doctors, nurses and other practitioners visiting our patients at home. We at present do not have a hospice, but efforts are being made to change that. We also do not have a dedicated palliative care team or ward within the only public hospital on the island, and referrals to palliative care to me and other palliative care doctors are perhaps not reflective of the actual palliative care need on the island. In Jamaica, which is much larger than Barbados, there is a dedicated hospice, which is used especially for patients who need to attend the nearby hospital for treatments but who live some distance away from the hospital.
The challenges faced in providing palliative care stem mainly from a lack of inclusion of palliative care in the public health framework of the island. There is therefore little acknowledgement by doctors who we depend upon to have the palliative care conversation with patients followed by referral to palliative care services. At present, instead of seeing patients who are referred at the time of diagnosis of their life limiting illness, we are instead being referred patients who have very advanced disease, are very close to death and no doubt have been suffering for some time prior to the referral.
One common misconceptions in the Caribbean is the belief that palliative care immediately means that your disease modifying or curative treatments have been abandoned and palliative care is just to support you until you die. Needless to say, this is so far from the truth. Perhaps, the larger problem we may face in this region is a lack of awareness about what palliative care even is, what it involves, and that it is available in our setting.
I wish that everyone knew how beneficial palliative care is; that it improves the quality of life of not just patients, but also their families, and that it is patient-centered care!
I started making TikTok videos during our first COVID lockdown in early 2020, at first I only did funny videos, but then realizing my reach, I decided that it may be useful to also create videos with the purpose of education others about palliative care.
The response to my videos have been more positive than I could have ever imagined! Lots of persons have said that they learn so much about palliative care from my videos, some persons had never even heard of it until seeing one of my videos! For practitioners of palliative care who see my videos, the feedback is also great with many of them wanting to share the videos to educate others. For me that is the most wonderful aspect of my videos because it means that I am getting the message about palliative care out!
My focus is on influencing policy to have palliative care included in our public health system’s framework. I also have dreams of being a TED speaker, and I am working towards that goal. Others can follow me on LinkedIn or visit my website.