Washington University School of Medicine Oral Histories
Tomasz Dangel Oral History
Interviewer
Bryan Sisk MD, MSCI
Files
Download Interview Transcript [PDF] (233 KB)
Summary
Tomasz Dangel was interviewed by Brian Sisk on July 23, 2019 for the Pediatric Palliative Care Oral History Project.
Scope and Content
Dr. Dangel begins the interview describing his experiences as a pediatric anesthesiologist witnessing children dying while receiving unnecessary aggressive treatment during the end-of-life. He also describes several pivotal experiences learning about and seeing other countries develop pediatric hospices. When he brought back his experiences to his home institution, he was not well received and consequently left to seek an environment to nurture his vision for pediatric palliative and hospice care.
Dr. Dangel comments that this was not his first time bringing new ideas into Polish medicine since he “introduced the modern techniques of regional anesthesia and analgesia in children,” in the 1980s. He then mentions that he was more than comfortable making the “conscious choice” to have his own “splendid isolation from the inhumane hospital medicine.”
He then describes the barriers he faced and overcame, such as lack of funding, training gaps for clinicians, no transportation for his staff, failing personal health, a research block from the ethnical committees in Poland, and “single case of malpractice at the medical court for using the ketogenic diet, which I designed for my hospice patient”.
Dr. Dangel goes on to describe his work in leading Polish medicine to establishing pediatric palliative and hospice care through his work in policy, peer-reviewed studies, publications, and books, public outreach, and coaching of other professionals. He also describes some of his biggest challenges today being lack of cooperation from the Polish government, lack of official accreditation, and government blocks on some palliative practices.
He then also describes the strengths of the current Polish practices of pediatric palliative and hospice to be the establishment of the Warsaw Hospice for Children Foundation who provide supportive services and organizational outreach as well as Polish societal values.
Finally, Dr. Dangel describes his vision for the future of pediatric and hospice care to be recognized as a branch of medicine in Poland, increase clinician knowledge and competency of palliative practices, increase the awareness and palliative training of other disciplines, such as gynecologists and obstetricians, establish a national research center, establish a journal of pediatric and perinatal palliative care, and to increase pediatric palliative and hospice consults with experts and ethics committees.
Biographical Information: Interviewee
Tomasz Dangel initially began his career as a pediatric anesthesiologist and oversaw Pain Management at the Memorial Hospital Children’s Health Centre in Warsaw, Poland. During his time working in the in the pediatric intensive care unit, he witnessed many children die while receiving aggressive and “inadequate life-prolonging treatment” where he thought it would be more appropriate to offer an option for end-of-life support.
Through a course he attended in 1991 and several pediatric hospice visits abroad, Dr. Dangel discovered adult palliative care practices and pediatric hospice practices, thus beginning his advocacy for a specialized pediatric palliative care practice at his home institution. Dr. Dangel envisioned a palliative service that would complement his in-patient pain management department. Unfortunately, his home institution and several others in Poland rejected his vision and failed to recognize the medical and spiritual need for a pediatric palliative service.
Dr. Dangel consciously chose to “splendid[ly] isolate[e]” himself from “inhumane hospital medicine,” and continued to work on gathering support and evidence for pediatric palliative medicine. He eventually established the first pediatric hospice in Poland.
Dr. Dangel has since successfully initiated pediatric and perinatal palliative care in Poland, established multiple children’s hospices in Poland, opened an educational center, conducted and published 15 epidemiological studies on pediatric palliative home care in Poland, co-authored the Polish standards of Pediatric Palliative Home Care and Perinatal Palliative Care, established the first committee of clinical ethics, and continues to research pregnancy and perinatal nutritional needs. He retired from the Warsaw Hospice for Children in 2020 after 25 years of medical work.
Biographical Information: Interviewer
Bryan Sisk, MD, MSCI is an Assistant Professor in Pediatric Hematology and Oncology and an Assistant Professor in General Medical Sciences as a member of the Bioethics Research Center at Washington University in St. Louis. He completed medical school at the Cleveland Clinic Lerner College of Medicine at Case Western Reserve University. He completed his clinical training at St. Louis Children’s Hospital and Washington University School of Medicine.
Dr. Sisk was a clinical fellow in pediatric hematology and oncology when he initiated this Pediatric Palliative Care Oral History Project. As a trainee, Dr. Sisk had a strong interest in palliative care, the approach to the suffering of children, and the history of medicine. Prior to initiating this project, Dr. Sisk performed an in-depth review of the development of pediatric palliative care as a discipline and philosophy. This research culminated in a publication entitled, “Response to Suffering of the Seriously Ill Child: A History of Palliative Care for Children” in the journal Pediatrics. However, this historical review was limited to textbooks and publications. It lacked the personal experience of caring for these children and inspiring the development of a new clinical discipline. Inspired by David Clark’s oral history of the adult hospice movement, Dr. Sisk began to plan this pediatric oral history project.
Of note, this collection of oral histories is incomplete, and many important figures have not (yet) been interviewed. Dr. Sisk’s goal is to continue adding to this collection create a rich repository of personal insights and wisdom from leaders who changed the field of pediatrics.
Interview Date
2019-07-23
Collection Identifier
OH154-S07
Restrictions
Users wishing to publish (in whole, or in part) content taken from the audio or transcript of this oral history interview must request, sign, and return a Statement of Use form to the Becker Archives. For detailed information regarding publication and use of this oral history, contact the Becker Archives (arb@wusm.wustl.edu).
Recommended Citation
Tomasz Dangel Oral History, OH154-S07, Bernard Becker Medical Library Archives, Washington University in St. Louis.
Disclaimer
The Becker Archives provides access to this oral history interview as a record of the past. This interview reflects the attitudes, perspectives, and beliefs of the interview participants, which may reflect outdated, biased, and offensive views and opinions. The Becker Archives does not endorse the views expressed in this interview, which may contain materials offensive to some users.
Notes
There was no audio recording created for this interview. Dr. Dangel's responses were provided in writing. The transcript combines the interview question and responses together.