Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Death is inevitable. Talk about it.

Shaleen Thakur, MD
Physician
July 3, 2022
1 Shares
Share
Tweet
Share

I had a patient in the ED who reminded me a lot of my grandfather, my Dada. I grew up with my Dada, listening to his stories and learning from his knowledge of the intricate workings of the world. He was a first-generation college student, science lover, world traveler, vice president of a large chemical engineering company and loving husband, father and grandfather.

When I was in high school, he also became a patient, diagnosed with Parkinson’s disease with the onset of dementia. This patient had a diagnosis and age like my grandfather’s. They were so alone and disoriented — I kept on looking over through their glass door to check in. And I felt the same protective urge to ensure that people treated them fairly that I did for my grandfather.

As my grandfather’s illness progressed, so did the whispers about him in front of him.

Family, friends, and strangers alike could not reconcile his condition — it was a frequent reminder of his mortality, each of our mortalities. “He is not what he once used to be.” “Oh, so sad.” These blunt but well-intentioned statements made the loss of his independence due to Parkinson’s cut deeper.

I wish we could have shielded him from these irksome comments. And at times, my sister and I did try, physically shielding him, diverting the onlooker’s attention elsewhere.

It was only at Dada’s doctors’ appointments that I saw his demeanor relax. He was a quiet, strong man who did not complain and highly valued his independence. Parkinson’s stripped him of this, day by day. We were lucky to have wonderful physicians taking care of him.

Having just graduated from medical school, I can appreciate the task of how his physicians pharmacologically managed his Parkinson’s. Still, I do think that his physicians may have made a few missteps.

A lot of the way we are taught to think about medicine is very black and white. If someone over 70 is diagnosed with Parkinson’s, Carbidopa-Levodopa will be the drug of choice. It is what my grandfather was on.

Yet I experienced that there were more intricacies to it than that. He had unwanted side effects that considerably interrupted his quality of life. I often wonder what conversations could have been had during his doctors’ appointments regarding his goals of care. Were there different conversations being had with someone newly diagnosed with Parkinson’s at 50?

I was quite excited to start my third year of medical school, my introduction to the clinical world of medicine — to learn how I could become the type of physician my grandfather had had.

I met Mr. N as I was leaving the general internal medicine inpatient service. He was a lovely 91-year-old gentleman who, unfortunately, was admitted with a 10-liter oxygen requirement due to his COVID-19 infection.

Usually, he would have been sent to the ICU with an oxygen requirement of over 6 liters, but he had signed a DNR form, so his family and physicians decided to keep him on the floor.

In our workroom, the conversations surrounded our sorrow at his likely passing. I was beyond relieved to learn from his chart while on my next service that Mr. N was safely discharged home! We had not even entertained the chance of his recovery, had not pursued a transfer to the ICU and yet he was able to go home to his wife and family. He was 91, so we had decided for him that these were to be his last few hours. My grandfather was 80 at the time of his diagnosis.

The next rotation I had moved onto was pediatrics — a stark contrast from the patient demographics I had cared for during my time on internal medicine.

During my time on the inpatient pediatrics service, I met a 6-month-old infant, on the opposite end of life to Mr. N. This baby had come in with a heart-wrenching story.

Their father had physically abused the child to the brink of death — all measures were taken to resuscitate this baby. And now they were going to be in a vegetative state permanently. Everything had been done, and the outcome was gut-wrenchingly different from that of Mr. N’s. But why had everything been pursued for this baby when there was essentially nothing left to be done, whereas Mr. N’s recovery had been left to fate?

Mortality is definite, and our finiteness as individuals on this earth is frightening. But approaching our mortality with openness and honesty can help lead to a dignified end. I was in my junior year of undergrad, taking a class called “Death and Dying,” when my grandfather passed away after six years of his illness.

It will forever be one of my biggest losses — my mentor, my best friend, my Dada. I was always so uncomfortable at the thought of his passing, especially as he became frailer — at the slightest change in his health, I would panic. This class’s main assignment consisted of three reflections regarding our thoughts on mortality.

My first reflection was written four days before my grandfather’s death. I spoke of my fear of his passing, having written, “I could not imagine what my life would be like without Dada.” And unfortunately, I had to find out soon after that. However, I think being in this class during this time forced me to think about mortality rationally — I was able to celebrate his beautiful life rather than lament its loss.

If it is a conversation you are willing to have, I implore you to discuss the events surrounding the ends of our lives with your loved ones and patients. There was a day during his last year of life when my grandfather turned to me and said, “I will probably die soon.” But I shied away from the topic and brushed it off. I told him to stay strong, and I regret my response every day. My sweet, wonderful Dada was ready to have that conversation, and I wish I had been too.

Shaleen Thakur is an internal medicine resident.

Image credit: Shutterstock.com

Prev

Creating community solutions for children's health

July 3, 2022 Kevin 0
…
Next

Treating pain without medication [PODCAST]

July 3, 2022 Kevin 1
…

Tagged as: Palliative Care

Post navigation

< Previous Post
Creating community solutions for children's health
Next Post >
Treating pain without medication [PODCAST]

Related Posts

  • A physician joins TikTok to talk sex education

    Jennifer Lincoln, MD
  • Physician suicide: We need safe spaces to talk about it

    Ton La, Jr., MD, JD
  • Let’s talk residency: COVID edition

    Angela Awad and Catherine Tawfik
  • I challenge you to discuss death

    Emily S. Hagen
  • My grandfather’s death: What I’ve learned about life

    Munera Ahmed
  • Death and Dvořák

    Daniel Song

More in Physician

  • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

    Anonymous
  • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

    Veronica Bonales, MD
  • A mentor’s legacy in medicine, leadership, and embracing evidence-based care

    Arthur Lazarus, MD, MBA
  • Breaking free from restrictive covenants to combat burnout

    Raya E. Kheirbek, MD
  • From medical student to intern: Discovering a deeper connection with patients

    Johnathan Yao, MD, MPH
  • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

    Jennifer Lycette, MD
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • A revolution in patient empowerment: Working together to save our medical system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • Unlock financial freedom: The physician’s guide to lucrative multifamily syndications and wealth accumulation

      Pranay Parikh, MD | Finance
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • New Antiviral Option for CMV Prophylaxis After Kidney Transplant
  • Infant RSV Vax Heads to FDA for Review
  • Is Getting Test Results Online Right Away a Good Idea? Yes, Patients Say
  • Residency Application System Cuts Section on Hobbies and Interests
  • Workplace Harassment, Cyber Incivility High for Minority Groups in Academic Medicine

Meeting Coverage

  • Phase II Study: Bispecific Oral Drug Tops Leading JAK Inhibitor for RA
  • Closing the Diversity Gaps in Urologic Oncology Leadership
  • Certain NSCLC Patients May Be Able to Stop Immunotherapy at 2 Years
  • No Survival Benefit With Immune Checkpoint Inhibitor Rechallenge in Metastatic RCC
  • Happy Sleep, Happy Couple?
  • Most Popular

  • Past Week

    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Boxing legends Tyson and Foreman: powerful lessons for a resilient and evolving health care future

      Harvey Castro, MD, MBA | Physician
    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • Decoding name displays in health care: Privacy, identification, and compliance unveiled

      Deepak Gupta, MD | Physician
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • A revolution in patient empowerment: Working together to save our medical system [PODCAST]

      The Podcast by KevinMD | Podcast
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • Unlock financial freedom: The physician’s guide to lucrative multifamily syndications and wealth accumulation

      Pranay Parikh, MD | Finance
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
    • From journalism to medicine: Unveiling the untold stories of patients’ medical conditions

      Veronica Bonales, MD | Physician
    • Unlocking resilience: a powerful journey from trauma to transformation [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...