INSIDER'S VIEW ON TERMINAL ILLNESS

I worked with terminally ill patients: Here is what I learnt about health and lifestyle

An individual’s perspective on life shifts with every encounter outside their immediate frame of reference. Prior to working in clinical research at the hospital, my understanding of terminal illness was confined to textbook definitions. The reality of it settled in during my first patient encounter, hearing a woman had less than six months to live. I thought to myself- six months? Six months is not enough time for a birthday or a seasonal celebration. Witnessing high mortality rates firsthand illuminated something profound about life that continues to stay with me. It was a turning point for how I approach my own health and wellness. The following are some lessons I learnt while working with terminally ill patients.

1. Every Action Is Cumulative

Working in the pulmonary and critical care department, I witnessed numerous deaths resulting from cardiovascular and pulmonary illnesses. I remember a particular conversation with a patient’s relative. A patient’s older sister said, ‘When I was your age, I was always moving around instead of sitting on the couch all day. Now look at me. I told my sister to do the same, but she did not listen. She always had one health complication or the other, combined with poor lifestyle choices such as smoking and a bad diet. Even now that my sister is sick with pulmonary hypertension, she still loves to drink Coke.’

This statement revealed that every single action we take counts and is progressive. The daily can of soda consumed to unwind after a long, hard day, it all accumulates. This is why walking at least 10,000 steps per day is widely recommended. Even 7,000 steps makes a significant difference. The goal is to keep the body moving.

Research published through Harvard Health Publishing supports this principle. According to Salamon (2024):

Researchers learned that taking between 9,000 and 10,500 steps each day lowered the risk of early death by 39% and the risk of heart attack or stroke by 21%. But any number of daily steps above 2,200 lowered the odds of early death and heart disease regardless of how long people spent being inactive each day. Health outcomes continued to improve with the more daily steps participants took.

Additionally, scientific research demonstrates that a sedentary lifestyle contributes to skin breakdown, lower extremity swelling (edema), and abnormal changes in metabolic rate (Chipperfield, 2008). These are not myths, but scientific evidence proving the outcomes of a sedentary lifestyle. As you are reading this, I hope you are motivated to stand up and go for a walk.

2. Lifestyle Is Easier to Change Than Illness Is to Reverse

Another lesson I learnt from my time with terminally ill patients is that most illnesses are far more difficult to reverse than lifestyle habits are to change. Drug development requires years of research. Finding the right medication for a given patient involves considerable trial and error. Even when a drug proves effective, it often introduces side effects that require additional medications to manage. The compounding complexity of treatment stands in stark contrast to the relative simplicity of prevention.

Lifestyle changes suited to better wellness can begin with small, intentional choices: substituting sparkling water for soda, parking further away to allow for a longer walk, choosing the stairs. Change is always available to us. The best time to begin is always the present, rather than to wait for the regret that the future may bring.

3. Diet Is More Consequential Than Most People Realize

Another lesson I learnt is the profound and often underestimated role that diet plays in health outcomes. A large-scale study analyzed 75,230 women from the Nurses’ Health Study (1984 to 2020) and 44,085 men from the Health Professionals Follow-Up Study (1986 to 2020). Investigators found a significant association between adherence to four healthy eating patterns and a 20% reduction in the risk of early death. Participants who more carefully followed any of these patterns, all of which shared a focus on consuming more whole grains, fruits, vegetables, nuts, and legumes, were also less likely to die from cancer, cardiovascular illness, and respiratory and neurodegenerative disease (American Medical Association, 2023).

The key to dietary improvement lies in consistency and sustainability. Just as with lifestyle choices, starting with minimal substitutions and maintaining them over time produces lasting results. For the same plate size of food, consider reducing the portion of refined carbohydrates while increasing the proportion of protein and fiber. This approach is gradual enough for the mind to accept and sustain, yet impactful enough to shift long-term health outcomes. I remember the moment a pulmonologist, with over 15 years of experience working with critically ill patients, told a patient who was requesting additional medications: ‘You are already on too many medications. If this is not working, you need to incorporate more of these foods into your diet.’ Those words echo loud into my ears how critical nutrition is to our wellness.

4. The Mind-Body Connection is not a facade

Perhaps the most lasting lesson I gained from this work concerns the power of the mind-body connection. Mental health is as important as physical health, and the attitude one brings to illness can meaningfully influence its progression.

There was a particular patient living with pulmonary hypertension who stood apart from others in her unit. She was on minimal medication compared to her peers, and her laboratory and diagnostic results were consistently notably strong. The distinguishing factor was her mood. She was consistently joyful, even in the face of a terminal diagnosis and the pain that accompanied it. She told me, ‘Busola, it is important to remain happy. I try not to be depressed, and I always find something I can be grateful for.’ That was remarkable.

Her experience is a vivid example of how emotional well-being interacts with physical health outcomes. Being intentional about maintaining a joyful and grateful outlook is not merely a coping strategy. It is a health practice. Gratitude is a choice. Can you commit to noting down at least 3 things you are grateful for?

Conclusion

These lessons, drawn from my time spent working with terminally ill patients, reshaped my understanding of the precious value of life and time. These lessons inspired me to make deliberate lifestyle changes and to be intentional about what I do for both my body and my mind. Health is wealth. Health is all-encompassing. It encompasses what we eat, how we move, what we think, and how we choose to feel. The invitation to live a healthy lifestyle is always open, and it begins with a single, intentional step.

References

American Medical Association. (2023, February 16). Diet patterns that can boost longevity, cut chronic disease. https://www.ama-assn.org/public-health/prevention-wellness/diet-patterns-can-boost-longevity-cut-chronic-disease

Chipperfield J. G. (2008). Everyday physical activity as a predictor of late-life mortality. The Gerontologist, 48(3), 349–357. https://doi.org/10.1093/geront/48.3.349

Salamon, M. (2024, July 1). More than 2,200 steps a day might help you live longer. Harvard Health Publishing. https://www.health.harvard.edu/healthy-aging-and-longevity/more-than-2200-steps-a-day-might-help-you-live-longer