Dr. Ranjana Srivastava is an Indian origin oncologist based in Australia, award-winning writer and geriatric cancer specialist. A two-time Fulbright scholar, she advocates for compassionate doctor–patient communication, elder care and end-of-life planning. As a regular fortnightly columnist for The Guardian newspaper, she bridges medicine, society, empowering patients and reflecting on the human side of modern healthcare.
From Bihar to the World
Dr. Srivastava was born and raised in Bihar during the 1980s, a time when infrastructure such as electricity, water and transport was limited. Despite these challenges, her school Mount Carmel in Bhagalpur served as a sanctuary. There, she found enduring friendships and dedicated teachers who invested deeply in students’ growth. These formative years instilled in her a strong work ethic and a sense of possibility that continue to shape her professional life.
As a writer, Dr. Srivastava draws heavily on her early life experiences. Growing up in Bihar, particularly during long summers without phone or television access, encouraged her to read extensively and later to write. This habit carried into adulthood and once she became a doctor, she realised that medicine offered a perpetual fertile ground of ideas.
Learning Across Continents
Fluent in English and Hindi, Dr. Srivastava has benefited from a global education spanning India, the United Kingdom, the United States and Australia. She holds medical qualifications from Monash University and the Royal Australasian College of Physicians, a fellowship in clinical medical ethics from the University of Chicago and a Master in Public Administration from the Harvard Kennedy School of Government, where she also received the John F Kennedy Merit Award. Ranjana is a keen believer in the power of education to shape our lives and supports educational initiatives around the world.
Geriatric Oncology and Whole-Person Care
As a specialist in geriatric oncology, Dr. Srivastava highlights elderly patients are typically left behind by healthcare systems even though many countries are facing an ageing population. Older individuals often live with multiple health conditions and may struggle to advocate for themselves. When they develop cancer, she believes they have a special case for being treated with care and concern for their overall well-being.
She explains that geriatric oncology is a relatively new subspecialty that treats the whole person rather than just the cancer diagnosis. A major challenge in treating elderly patients is that most clinical trials exclude individuals over 65 or those with multiple comorbidities. As a result, treatments based on such trials may lead to increased side effects and complications in older, less fit patients. She says it is well documented that patients in their eighties or nineties do not necessarily wish to prolong their life at the cost of toxicity but they do want to preserve their quality of life and independence.
A key mission of geriatric oncology, she says, is to improve health provider awareness of the special needs and vulnerabilities of elders. This helps to open a conversation about the goals of the elderly person so that cancer treatment is aligned with their wishes. Not all elderly patients are the same and we must be careful to not dismiss people on the basis of their age. At the same time, expecting an eighty-year-old to cope with side effects like a forty-year-old is not appropriate. The reason she is drawn to geriatric oncology is that it really does aim to honour the whole person.
Doctor–Patient Communication and Humanising Medicine
In the area of doctor–patient communication, Dr. Srivastava emphasises that kindness and empathy are fundamental human needs, particularly during illness and accompanying stress. She often cites William Osler’s observation that patients care less about how much a doctor knows and more about how much the doctor cares. She believes that while it is impossible for doctors to know everything, it is always possible to be more humane. For her, communication goes beyond conveying medical facts; it involves empathy, understanding and responsiveness to emotions.
She strongly advocates for formal training in communication skills, noting that such skills can be learned and honed, just like technical medical procedures like suturing or plastering. She believes medical students and practicing doctors should be systematically taught basics of good doctor–patient communication and assessed periodically. For those interested in this field, she frequently recommends the work of Dr. Anthony Back and his colleagues.
Writing as Reflection and Responsibility
A self-taught writer, she has authored several books and publishes a widely read fortnightly column in The Guardian on the art of medicine and and is the winner of prestigious writing awards. She is the recipient of the Medal of the Order of Australia for her contributions to doctor–patient communication and the winner of the Human Rights Commission Literature Prize.
She considers writing primarily a personal practice that helps her make sense of the world and stay grounded. As she began to write more, she found that other people responded to it and sometimes found it helpful to find their thoughts reflected in her observations. This encouraged her to keep writing.
She has now been a columnist for The Guardian for over a decade, an achievement she never initially anticipated. Writing for such a public platform, she believes, carries both joy and responsibility.
Through her writing, Dr. Srivastava seeks to address the power imbalance between doctors and patients by democratising medical knowledge. Her goal is to democratise medicine so that patients are better informed consumers and doctors are more reflective providers.
Every fortnight, she writes on issues that matter to the public, ranging from the art of medicine and latest research to policy matters, healthcare funding, end-of-life care, harassment, discrimination and broader social issues. She writes about anything that interests her hoping that it will also interest her audience.
End-of-Life Conversations and Dignity
Regarding end-of-life care, Dr. Srivastava believes, it makes sense to talk about it as a community. She observes that in many countries there is a lot of reluctance to discuss death and dying but she regularly sees how advance planning, open conversations with loved ones and clear instructions about what we want are helpful for the patient and relatives. The idea that we should leave these things to destiny actually puts tremendous pressure on those left to deal with end-of-life decisions.
She calls for end-of-life care to become a national conversation. Doctors, nurses and allied health professionals must address the myths and misconceptions and provide information in simple, clear terms. Even in countries with highly developed healthcare systems, she notes this is a taboo area. Therefore, it requires support, funding and rolling education (of doctors and patients) to bring people along.
Dr. Srivastava frequently examines the moral and emotional challenges faced by doctors in modern healthcare. She points out that increasing administrative duties and paperwork that consume a significant fraction of their time. Meanwhile, the scope of modern medicine is so large that it is impossible for any doctor to keep up with all the rapid advances.
Also, modern society has become transactional – people go to a doctor expecting a fix and are angry when they don’t feel well-served. At the same time, she observes a decline in societal respect for doctors, reflected in growing incidents of violence against healthcare workers around the world.
Although she acknowledges that medicine remains wonderful and gratifying work for many doctors, there are good reasons for the prevailing stress and burnout. Many doctors don’t want their children to enter medicine and many practicing doctors don’t feel motivated to remain in the profession.
She believes governments and institutions can tap into these issues and work with healthcare professionals to design more efficient and supportive healthcare systems. But unfortunately, she suspects that individual doctors will need to carry most of the burden of figuring out how to look after themselves better. This means asking hard questions like how much work is enough, what quality of life means to them and what they want their legacy to be. The answers will keep evolving but if we don’t stop to reflect, she fears we will cause ourselves to suffer.
Learning from Culture and Community
Having trained and worked across multiple countries, Dr. Srivastava believes global healthcare systems can learn valuable lessons from Indian cultural practices, particularly the respect and care shown to elders. She notes that family involvement – through commitment to their care in practical ways such as sharing living arrangements, attending medical appointments, visiting or calling regularly and supporting them emotionally. In return, our elders are often happily involved in teaching and mentoring the young. We place a lot of emphasis on being together for family events and teaching our children to respect their elders. It is impossible to overstate the importance of these small but frequent points of connection to help our elders thrive.
In contrast, she observes significant loneliness among elderly patients in Western societies, often stemming from distant family relationships and individuals being too busy with their own lives. Of course, people have their own reasons for the quality of their relationship with an elderly parent or relative but as someone who spends a lot of time talking to older patients, she notes that a large part of their problem is pervasive loneliness and the feeling that they don’t matter. She emphasises that feeling of abandonment is not something medicine can cure; it comes back to society and what we value.
As India continues to modernise, she hopes the country retains its tradition of valuing and caring for elders, noting that there is nothing ‘old fashioned’ about it.
Read more about Dr. Srivastava at www.ranjanasrivastava.com
