Tuesday, August 11, 2026

Zugzwang in Palliative Care

You never truly know who your next patient will be, and sometimes it turns out to be someone who left a lasting mark on your life.

I was stunned when I saw his name on the ward chart today. Standing before me was a prominent figure from our local chess fraternity - a stern educator and team leader from our fiercest rival school 20 years ago. Truth be told, back then, we didn't particularly like him. He was an alpha male who is tough, uncompromising, and determined to win.

Fast forward two decades, and the boards have completely flipped. Our palliative care team was called in to support him as he faces a life-limiting illness, having exhausted most treatment options.

When I first walked in and greeted him, I honestly didn’t know what to say. The room felt heavy with uncomfortable silence. I have been doing serious illness conversations for years, but this caught me off guard. How to bridge the gap between a stern rival mentor from my youth with a proud man facing his quietest, hardest trial is still the question lingering in my mind.

We exchanged a few moments and had a very simple chat on how I could make him feel better. No long stories, no chit chat, just straight to the point. His face suggested that he was keeping all his thoughts to himself.

I left in a jiffy, looking forward to meeting his son coming back from overseas on Monday to talk about future care plans.

Medicine constantly reminds us that life comes full circle. You never know who will be sitting on the other side of the consultation room.