The summer of 2020 is easily one that I would rather forget but has been one that, I believe, will be etched in my memory for a very long time.
After a brief vacation to visit my maternal relatives in India during last winter break, I welcomed 2020 with some good news: I had been selected for a clinical research internship on an aging population study at the National Institute of Health in Baltimore over the summer, after my first year of medical school. But that was pre-COVID. Then came March and the lockdown. Our medical school switched to online instruction. I returned home to the Seattle area. In April, I learned that the internship program was canceled for the summer. I was stuck at home with my summer plans derailed. It seemed from this bizarre sequence of events that my world had turned upside down.
Then, out of the blue one late May evening, my father experienced a mysterious ailment. “Sudden onset of spinning sensation last night with vertigo and sensation of uneasiness,” read the clinical history summary from his ER visit the next morning.
My mind had raced wildly as I attempted a differential diagnosis via Google while he was being evaluated in the ER. Ear infection? Stroke? A new manifestation of COVID?
Then I couldn’t believe my eyes as I read his report further “There is a somewhat lobular mass which extends through the right foramen of Monro …” My heart sank. Did my father have a tumor in his brain? My mother’s grim look confirmed the gravity of the diagnosis. My dad, in his usual stoic self, handled the news with equanimity. Fueled by my worries about the prognosis, I started researching specialists’ names to consult for follow-up evaluation. Coincidentally, I had shadowed two neurosurgeons during my pre-med years and reached out to both of them. Based on their recommendations, we set up teleconsult visits with sub-specialist experts in the field. Even though the MRI did not indicate that the brain mass was fast-growing or even whether it was directly related to his symptoms, the consensus was that it had to be removed based on its location.
A few days later, my mother got a call from India. My grandfather had had a fall and incurred a subdural hematoma (bleeding in the area surrounding the brain). Getting proper care in the face of a lockdown and an upsurge in COVID cases in New Delhi became a real challenge. My mother, who was very close to her father, and already stressed by my father’s health issue, struggled to maintain her composure. Now, my world had really turned upside down!
What followed was an emotional rollercoaster.
I juggled between reading about brain tumor types (gliomas, subependymomas, cysts, etc.) and craniotomy recovery prognoses during the day, and sitting in on FaceTime calls between my mother and her siblings on care options for my bed-ridden grandfather, late in the evening. I watched my mother agonize over the emotion-laden disagreements between her siblings on the hard care decisions that had to be made (ICU hospitalization – yes, life-saving craniotomy – yes, tracheostomy – no), while feeling helpless being 7,000 miles away.
My father had his operation and was admitted to the neuro-ICU for monitoring. He challenged himself shortly after the surgery to determine what cognitive, and motor functions were intact – such as by attempting to write down our names. He calmly reassured us that he was OK despite the worried look on our faces. Although only one of us was permitted in the neuro-ICU at a time due to COVID restrictions and there were COVID patients in an adjoining wing, I was grateful that we were allowed at all to be with him. Once home, his care team consisted of my mom, myself, and my younger brother. We took turns sitting with him, assisting him with meals and walking, and making sure he had his medications. Although we were focused on his recovery, unspoken financial worries were in the back of our minds – we were now dependent solely on my mother’s income, as it wasn’t clear when my self-employed father could return to work. Meanwhile, we were keeping him occupied by working together on jigsaw puzzles and playing board games.
Unfortunately, our saga did not have a perfect ending. My grandfather was never able to truly recover after his surgery and his health issues compounded – from his weak heart to his lungs to kidneys – he passed away a month after his surgery. We had brought him back home so he could depart in peace with the family. Constrained both by distance and the pandemic, we said our tearful goodbyes over FaceTime.
I think we all grew a bit this summer. My mother learned to be the emotionally strong one during a time of high stress, and my younger brother learned to assume responsibility without being told what to do.
As for me, I feel that I grew up both professionally and personally. I experienced first-hand what it feels like to be in the shoes of someone caring for a family member with a life-threatening condition. I learned that abstracting the treatment of patients merely as subjects with an ailment (as it is typically presented in medical school) is only solving part of the problem; they still need an appropriate care ecosystem at home for their recovery, however, improvised it may be.
I also realized from my grandfather’s health treatment that care decisions for the elderly can be very hard and painful – and that medical practitioners can play a helpful role in educating families on good palliative and end of life care.
Personally, I felt that I was tested to stay calm and focused during a family crisis. Above all, I learned not to take my own family for granted.
My father is slowly recovering from his surgery, which was successful – I will cherish the quality time we spent together as a family in taking care of him. I miss my grandfather, but I’m also grateful to have had the opportunity to visit him last winter over the holiday break.
In a time where lives have suddenly been disrupted by the COVID pandemic, I cannot but feel thankful and say to myself: Family matters.
Rohan Sehgal is a medical student.
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