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

“His echo results came back, and his ejection fraction is 25%. It looks like the infection has overwhelmed his heart.” As the ICU resident said this, I felt my own heart plummet. My family members looked at me with confusion, trying to understand what this new information meant.

Several days prior, my grandpa had been hospitalized for pneumonia caused by Legionella. When we first received the diagnosis, my family and I were confident that it could be treated. I ran through what I knew about Legionella, fresh from my second year of medical school. But even though the right antibiotics were started, my grandpa’s condition rapidly worsened over the next few days.

His kidneys were failing, his blood pressures kept dropping, and he needed to be intubated. I had heard the term before: septic shock. The infection from his lungs had gotten into his bloodstream and was affecting his other organs. His heart function was the only hope we had left that he would somehow pull through. Now, that hope had been dashed; I knew my beloved Papa was dying.

Medical student vs. grieving family member

Looking back now, I realize how unique my position was. I was going through medical school, achieving my dream of becoming a physician. I had learned about the body systems, how to gather histories and physicals, what lab work and imaging to order, and how certain diseases are treated.

Because of this, my family relied on me heavily to interpret the medical jargon, test results and procedures that Papa had in the hospital. They included me in making medical decisions once he was no longer able to make them.

While I was confident in my medical knowledge, I felt unprepared to find myself on the patient side of medicine. It was difficult to feel the emotions I needed to feel during the course of Papa’s illness. The analytical side of my brain was always “on,” interfering with my ability to grieve as he grew sicker.

Perhaps my medical background and responsibility to translate for my family were a defense mechanism, a way of intellectualizing what was happening rather than feeling the emotions that I feared would debilitate me. It wasn’t until my cousin, a fellow health care worker, asked how I was really doing that I finally took a step back and allowed myself to feel.

Closure and lessons learned

“Time of death is 6:36 p.m.,” the ICU resident said as she finished the final examination. I was the first of my family to make it back to Papa’s bedside after we had been ushered out of the room to allow the medical staff take him off the ventilator. His heart had stopped, and his code status was DNR, a decision my mom and I made earlier in the day since we felt that was what he would’ve wanted.

Papa’s battle with sepsis was over. Shortly before Papa’s heart rate dropped, I noticed that his oxygen saturation had decreased to 80% despite being on maximum ventilator settings and supplemental oxygen. I knew that his body would decompensate quickly and he didn’t have much time left.

I explained this to my loved ones, and we all spent as much time as we could with him in his final moments. As my family’s mourning period began, I was comforted that my medical knowledge helped give them extra time to say their goodbyes.

My experience on the patient side will ultimately make me a better physician. My family was lucky that they had someone in their life who could translate medical information for them.

Remembering that, I resolved to do my best to make sure my patients and their families understand what’s going on so they can make the most informed decisions for themselves.

Another thing I learned during this experience is that while being a medical student and future physician is an important part of who I am, I can’t neglect the other parts of my identity either.

I can be both a future physician and granddaughter grieving her grandfather. I can be both objective and check in with myself emotionally, too. I miss my Papa dearly, but I take comfort in knowing that he helped me learn how to make an impact on my patients’ lives.

Related reading:

From medical skeptic to grateful and compliant: My recent patient’s transformation

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