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During his training at The Johns Hopkins University School of Medicine in Baltimore, Anirudh Rao, MD, found the most meaningful cases to be those involving end-of-life issues, including those with difficult, often emotionally painful decisions for patients and family members.
"The opportunity to do things that aligned care and treatment with a family’s goals was very fulfilling,” Dr. Rao says. “That’s when I decided to focus my career on palliative medicine.”
Dr. Rao was 10 years old when his family moved from India to New York. A magna cum laude graduate of Cornell University, Dr. Rao came to Johns Hopkins for medical school, and stayed for a combined residency in Internal Medicine and Pediatrics, and a fellowship in Hospice and Palliative Medicine. He joined MedStar Washington Hospital Center’s Section of Palliative Care as an attending physician for the research and mentoring opportunities, and to help train fellow physicians in the discipline.
“I also liked the fact that the patient population is similar to Baltimore’s,” Dr. Rao adds. “The diversity of backgrounds and cases is both familiar and challenging.”
Addressing Misconceptions around Palliative Care
In working with families, Dr. Rao sometimes has to address misperceptions about palliative medicine, particularly concerns that it heralds a significant transition in a patient’s care strategy.
"I try to educate them that we can do palliative care in conjunction with other treatments, and that we can still treat the symptoms of an illness as well help alleviate their effects,” he explains.
Establishing and maintaining dialogue with the family are likewise essential elements of palliative care.
"Certainly end-of-life discussions are important, but we try to get involved well before it reaches that point,” Dr. Rao says.
If a patient is scheduled to receive a heart-assist device, for example, Dr. Rao will work with the patient and family to clarify expectations and goals. “Building that kind of understanding and environment for decision-making is very good for the patient,” he adds.
Keeping Up with Research
Dr. Rao looks forward to continuing investigations on topics such as how advanced heart failure interventions and therapies affect patients and their quality of life, and how to improve the experience of patients whose treatment is no longer effective. He’s also interested in following up on patients who received palliative care as children, and how to improve the transition of care once they reach adulthood.
With a caseload made up mainly of difficult, often emotionally-wrought end-of-life issues, Dr. Rao has to maintain his own balance of professional objectivity and personal empathy.
“I’m there to provide patients and family members with good information, and support them emotionally,” he says. “If I’m able to come away with that, regardless of what they decide, and what happens, I’ve done my job.”
Life Outside the Hospital
Along with reading and regularly documenting his challenges for future reference, Dr. Rao stays active with tennis and racquetball. He also enjoys family time outdoors with his wife, who is an ob/gyn at a community hospital near Baltimore, their two-year-old daughter and their dog.
“They’re the best coping mechanisms of all,” he says.