No R/S: Point of No Return

My young colleagues,

It is an excellent opportunity to communicate with you through this unique platform. You, on your own, or from your senior colleagues will learn a lot about principles and practice of modern oncology and help the society, in more than one ways. These days management of a patient with cancer is well planned – from the outset to a final outcome, whatever that outcome could be!

I will try to broach upon a different topic today.

When I moved to Bombay (now, Mumbai) in May 1981, to train in oncology, I was instantly staggered with the city medicos' love affair with the abbreviated form of various medical words and sentences. One that completely floored me was, “No R/S” – a cryptic lingo that was well understood by older physicians and the medical record department of Tata Memorial Hospital (TMH). It meant, No Return Slip; in other words, “Please do not return for follow up. We tried what we could.”

It was that simple for us to write in the case file – a closure of sort. However, it kept on disturbing my conscience. In subsequent years, I stopped writing those two words and tried to give a short case summary, using some words of comfort, scaling down the harshness of reality. Of course, it was not possible to do for all, in an insanely busy hospital like the TMH. My language evolved from the often harsh medical terms to milder tones. That was our palliative care.

At times I address my audience who are usually younger colleagues and ask – “have you ever handed over a Death Certificate to a patient?” No one can imagine doing that – a death certificate to a person who is alive! But, you have always been doing that. To emphasize the point, I tell the story – half-truth and half-fiction. It goes like this.

Publication History

Article published online:
03 June 2021