Lessons in Death

I've had the fortune of having most of my loved ones relatively healthy and well for the majority of my life. Relatives have passed away in the past, but I have never been that close to any of them to feel much. My great grandfather's passing lingers as a distant memory of my childhood when my brother and I found it then comical at the grieving wails of my familial members at the funeral service.

This year of 2015, both my parents have experienced the grief of losing their most important loved ones. Earlier during the year, my mother lost her grandmother, who had raised her and put her through high school and university. I remember seeing my mother shed tears when she visited her grandmother in October, 2013 - joyful but sad. In the midst of the pre-boards studying ascending tension, I remember calling her a few times and hearing her tearful voice tell me she's okay. She had known her grandmother had been frail and entering stages of dementia for a while since our last visit, but it still grieved her greatly. 

Then, my father received news that his father had passed away earlier this morning. After a year of stepping in and out of the coffin, my grandfather finally passed away at the age of ninety-four. He had suffered two strokes throughout the earlier years, and I remember my father being extremely depressed when he received news from Taiwan each time. 

Both of my parents are extremely loyal and good children. Their greatest regret of coming to the States was their inability to take care of their guardians and look after them when they fell ill. When my grandfather was admitted to the hospital, the greatest struggle for my father was the conflicting desire to be present for his father in Taiwan and the familial obligation to continue working. He didn't have enough vacation days, and my mother made the good point of wasting vacation days if my grandfather turned out okay. 

When my father came home from work today, he seemed tired and depressed. Seeing his red-rimmed eyes, I knew he had shed private tears sometime during work. Being an extremely optimistic man, my father didn't really know how to handle catastrophically bad news usually. I was worried that he would be extremely depressed to the possible point of dysfunction, but he seemed fine. He was quiet, tired - the usual bounce and zen-ful humor lacking in his demeanor.

And it's strange. I've never been close to my grandfather. He had lived with us briefly when I was young, but I don't remember much about him. All I know is that my father deeply loved his father. I know it brought him such great sorrow not being able to be there for him and support him through his eventual deterioration of his physical health. The passing of life is a natural process of nature, but it's still painful for those still living. In the midst of board studying, where my end goal is to become a physician, it's a reminder of the vulnerability that not only patients face, but the patient's loved ones must endure in the aftermath regardless of the outcome. I know now, even indirectly, the sorrow and pain of losing someone dear to you in such a permanent way.

It saddens me that as I think about my medical education thus-far and leaf through my First Aide, I realize that nowhere in these pages contain information about how to comfort and provide support for those in the aftermath of death. My longitudinal Evidence Based Medicine and Healthcare, Care and Society curriculum of two years have been shining the limelight on the physician-patient relationship. We have discussed at length how to appropriately care of patients with respect and well-learnt professionalism. Perhaps in passing we have mentioned the toll on the patient's loved ones and how as physicians, we should help guide them through their personal journeys. Perhaps it's not our role as physicians. Perhaps there's nothing we can do but allow them to grieve. 

And I hope that, after I pass this dreadful "quiz" in four weeks (fingers crossed), when I finally become a fully fledged physician, I will have the capacity and grace to notice the suffering that not only impacts the patients, but their loved ones as well. I hope that I may be able to offer closure and solace to the surviving victims left living at one's passing.