My quest for immortality: I wanted to always be around so I could take care of my brother

“It’s not that bad. You tie a red string and get money.”

Those were the words of wisdom my older cousin whispered to me when I loudly complained about the itchy sequined dress that I wore on Raksha Bandhan, or Rakhi, as I sat waiting for my family to organize the materials for the event. At that moment, I perked up to the idea of a gift, completely oblivious to the true meaning of this religious festival.

As I grew older and began to practice my faith, I learned that, on this day, Hindu women of all ages tie a sacred amulet called rakhi around the wrists of their male relatives, promising to pray for their wellbeing. In return, they offer gifts and make a solemn promise to protect and care for their female relatives. However, as I grew older, I quickly realized that the festival takes on a unique twist in my family.

A daunting diagnosis

When I was around 7 years old, my younger brother, Venkat, was diagnosed with autism and intellectual disability at 4 years old. My parents, being young themselves, were deeply concerned and overwhelmed about his future. I vividly remember the moment where my family sat in our car outside of our apartment one day after school. My mom called for me; I was playing with my dolls, but I put them down, sensing the gravity of the situation. She was crying, and told me quietly, but earnestly, to always protect my brother and care for him, no matter how challenging it might become. I nodded, not fully comprehending the complexity of the situation, but I knew that I wanted to make my mom and dad feel better.

I would then repeat that action again and again as I grew older. Whenever I hung out with my friends, I always tried to include my brother, whether we were playing outside or celebrating at a birthday party. However, this is not to say that I was always a good big sister; in fact, I vividly remember an instance when I threw a temper tantrum about having to take Venkat along for the day, and to be responsible and keep an eye on him, instead of just having fun with my friends. My parents immediately comforted me, telling me to go ahead without my brother for this event.

When I returned, they told me that while I did not have to always take Venkat to my events, my brother did not have his own circle of friends and seldom received invitations to fun events himself. Their words really stuck with me.

A promise made, a promise kept

After that day, I made sure to put more effort into spending time with Venkat and helping him have a diverse range of life experiences. For this reason, as each Rakhi festival approached, I took a moment to reflect as I delicately tied the sacred thread. With each knot, I felt a deep sense of responsibility and affection for my brother, and I couldn’t help but contemplate the role I had unknowingly embraced: That of not just an older sibling, but also of a protector.

In medical school, I continued to learn more about autism, intellectual disability and the associated comorbidities over time. I started to worry about my brother’s diet and exercise. In the past, he had some physical activity from school and his extended program, but he has since graduated and likes to relax and watch TV often. When my family and I consider intervening, we pause and reflect on how Venkat is missing out on the wonderful experiences and privileges that neurotypical individuals of his age have, so we let him relax and enjoy different foods. But my worries only increased as I grew older.

Over time, my anxiety began to affect my well-being, and I became quickly aware of my own mortality. Every time I stepped into a car, walked in the dark or turned the stove on, I felt a heightened sense of vigilance. The idea of death became a constant source of fear due to the realization that my brother’s welfare rested heavily on my shoulders. If I were to go first, I couldn’t rest in peace knowing I was leaving him behind, vulnerable to life and navigating the world without me. As a result, I began to think about ways I could make sure Venkat would be taken care of in the future no matter what.

Planning for the future

I strategized different ways to save money and looked into acquiring a rental property to accumulate passive income for my brother. These plans have become more imminent to organize and carry out as I apply to residency and race to graduation in May 2024.

After residency, I plan to build a house with an accessory dwelling suite where my brother will still live within my house yet retain his independence and routine. I also thought about setting up my own clinic to allow him to work there peacefully as an administrative assistant under my watchful eye.

Slowly, I became so caught up in my own swirling thoughts and ideas of building a future for my brother and me that they began to consume me, but a particular moment stopped me in my tracks.

Quality time

It was during my dedicated study period for board exams. I had been confined in my room for hours, consumed by my question bank and notes. Desiring a change of scenery and a bit of sunlight, I decided to relocate to the living room. As I settled on the couch with my study materials, my younger brother politely asked if he could sit next to me while playing old Indian songs, our shared pastime. I agreed, and we spent the next ten minutes reminiscing about the times we first heard the songs. As time elapsed, I needed to get back to studying and made a move to return to my room, but it was at that moment when my brother made a simple request that gave me pause. He asked if I could stay with him a while longer and just listen to music.

In the pursuit of immortality, I spent my time overthinking and searching for means to care for my brother after I am gone. I lost sight of the fact that it’s also incredibly important for me to spend quality time with my brother now, to cherish these moments and etch them into beautiful memories. Through simple acts of togetherness, like the one in the living room, I can also care for my brother in the present.

I began to spend more time with my brother as I wanted to prioritize the present. While the idea of my mortality still looms over me, I am hoping that my future partner and children will join me in loving Venkat so there will be more caring individuals present in his life for longer. This belief gives me immense reassurance and helps me sleep at night.

Important lessons learned

Growing up with my brother has taught me a profound realization: Every individual has someone dear to them and hopes for their health and well-being to be cared for with the same devotion they would personally provide. For this reason, I hope that both present and aspiring health care professionals alike extend the same level of care and compassion to our patients and their families as we would desire for our own. Our values should be centered on delivering unwavering support, profound empathy and the same heartfelt compassion that we have for our own family.

For this reason, in 2024, when I graduate from medical school and become a physician, I plan to have my brother also tie a rakhi on me. For I have been and always will be his protector, and, in his own way, he too is mine.

And to my brother, Venkat: I may not be able to give myself immortality, but I promise to give you the world in the time that we have, and I will try my very hardest to make sure you will be loved and cared for today, tomorrow and always.

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