Becoming the medical expert in my family

Monday, July 4^th, 2022.

I am at an all-American backyard BBQ and I’m feeling … out of place. Everyone is enjoying this national holiday without a worry in the world, while the gears in my brain spin so fast that I think I can smell something up there burning. Stories are exchanged about pregnancy and parenthood, reiterating my panic that I should be at home studying obstetrics and pediatrics, among many other topics.

Sure, the fact that work is on my mind 24/7 is part and parcel of the life of a medical student, but it won’t get much better as a resident or an attending. Some have warned that it may even get worse.

“Hey man, you signed up for this,” I am frequently told by the layperson. Besides, as the child of a physician, I really knew what I was signing up for.

My phone rings.

It’s my Sicilian mother, who I figure is simply continuing to live up to the stereotype by calling for the umpteenth time today to keep apprised of the exact whereabouts of her child.

I ignore the call. She texts me.

“Sorry to bother you. It’s an important Totò medical question.”

Totò, the nickname for Salvatore, my uncle and godfather. After living with dementia for many years, he fell just two and a half weeks ago and hasn’t been the same since. My mother whispers through the phone that something is very wrong with his eye, and in a snap I am quickly bidding everyone farewell while sputtering something about leaving for a medical emergency.

Perhaps I’m reading into it a bit too much, but I feel a silent air of confusion from my gracious hosts and fellow guests. “It’s a holiday,” they seem to be thinking. “Doesn’t that mean everyone is off from work and can just laze about?”

I don’t have time at this moment to explain that being the person in the family who is called during a medical emergency is an honor, one that indicates that everyone has instilled their utmost trust in you. A beautiful honor, yes; but also a lonely one at times.

When the past plays on repeat

The GPS clocks the drive at 12 minutes, but it feels never-ending. My mind races as fast as the traffic is slow, and before I know it I am lost in a montage projected onto the screen of my mind’s eye. I watch the highlights reel of countless holidays when my physician father would leave my mother, my brother and I behind as something larger than us called him away.

We are commonly warned before our first year of medical school that the demands of this career will have an unparalleled effect on our relationship with our spouse or partner. Even if they sign up for this life of their own volition, their seeming awareness of what is to come never quite measures up to the real thing.

Early understanding and patience can, unfortunately, wear thin under the weight of emotional fatigue and resentment. The months and years warp life around them into something unrecognizable, something that no one expected nor bargained for.

Lest we forget the innocent offspring born into this life, who had no say in their fate yet have to face its difficulties head-on before even speaking their first word. This is something I know all too well.

In a dark room, there is light

Upon entering Totò’s house, I make an immediate left to enter the Christmas Tree Room. As you might have guessed, this was the room where my aunt and uncle gave bloom to their Christmas tree year after year. A soft glow would hug the entire room, courtesy of the strings of lights strewn about, in harmony with the artificial candles in the windows.

I slow my pace and stop. The door frame is barricaded by a pair of thick curtains, which were mounted to keep out extraneous light and sound. I part the heavy cloth and enter the dimly lit room. A few scattered nightlights take the place of those decorative fixtures of Christmases past. Totò lays in a rented hospital bed with his eyes closed. A giant oxygen mask claws at his face for dear life, humming its cold electric melody.

Have you ever seen the 1939 film, The Wizard of Oz? There is a scene where the main characters are heading down a long hallway en route to finally come face-to-face with the Wizard himself. The reality of it all suddenly hits the Cowardly Lion, and he chickens out so badly that he takes a running leap through a nearby glass window, disappearing into the night.

Looking at my uncle in that first second, I feel my eyeballs beat to the left oh so subtly, taking note of the window just a few feet away and pondering the same escape. What was I thinking? I’m still a student! What do I know? It occurs to me that I now have only two choices: get up close and personal with thousands of shards of glass, or slap on my own Badge of Courage and soldier on.

All of my relatives are putting their faith in me to save the day, all but the one person who matters most, Totò himself. The dementia started taking him over long before I even decided to pick up my second attempt at a pre-med program. By the time I entered medical school, he had long forgotten who I was. Never again would he get to beam with the immense pride he had always expressed for my accomplishments. He would never get to see me as Dr. Eldin.

“Deve aprire gli occhi,” I say in Italian to his live-in caretaker, stating to her that he needs to open his eyes.

She leans over him and gently urges him to do so in his native language. I too lean over and join in, and within a few seconds of hearing my voice, his lids rise. His gaze is fixed straight ahead at the wall before he turns his eyes to make direct contact with mine. Then he smiles, his eyes emanating that light that went out long ago.

For the first time in years, he knows who I am.

It’s as though he’s seeing a long-lost friend who he hasn’t seen since his youth. I get choked up because I feel the same way, which takes me by surprise.

And for these quick few precious seconds, he gets to see me as that which I will one day be: a doctor.

Water, wash my conscience clean

Sixteen days later, on the morning after his funeral, I have a very strong urge to swim in my backyard pool. The same pool where, during my childhood, Totò would launch himself off of the diving board and part the water with such a force that Moses himself would be envious. I grab onto my colorful pool noodles and kick my way up and down the length of the pool.

I’m not wearing a watch and so have no idea how much time has passed by the time I am finally ready to do what I came to do. I let go of the noodles and break out into the stroke that Totò would inevitably perform after every parting of the Red Sea: the freestyle. Before my hand even enters the water for the first stroke, I feel the lactic acid sauteeing the muscles of my arms, still sore from carrying his coffin just the day before.

Turning my head from side to side with each stroke, I catch quick glances of those pool noodles at a regular rhythm. With every glance I see them floating farther and farther away, taking with them so much else of which I am letting go. 

I am letting go of Totò.

I am letting go of the guilt that I couldn’t do enough to save him.

I am letting go of the fact that I’m the weirdo of my mom’s family who no one understands, and am now instead the weirdo because I now possess knowledge that no one understands.

I am letting go of the childhood nickname that a family friend gave me as a kid, “movie star,” because when we were at the cemetery just the day before he quickly corrected himself and called me “doctor.”

And so, in the unusual quiet of this July morning, I am letting go of my life before I committed to becoming The Doctor In The Family.

Because there is no going back.

Related reading:

Beyond the Confines of the DSM V

How I navigated my grandfather’s death as a medical student