She stood there, eyes fixed on the motionless figure before her. Her brother, just 23, lay on the hospital bed. His eyes were shut. His body still, but his chest rose and fell with each shallow breath. The monitor beeped steadily, a reminder of the fragile line between life and death.
She was three years younger, but their bond was deep. They had grown up together in a small village near the hospital. He had just started working at a private bank two years ago, helping women in the village form small savings groups. This month, he was expecting a reward—a decent bonus for hitting his loan target. It was supposed to be his breakthrough, the moment he’d been waiting for.
But destiny had other plans.
On a rainy evening, as he was heading home after work, The roads were dimly lit, the drizzle making everything slippery. He was on his two-wheeler when a speeding bike collided with him. He was thrown to the ground, his head hitting the pavement hard.
Unconscious on the road, he was recognized by the woman he had helped, the one he had lent money to. She quickly grabbed his phone, dialled his mother’s number, and called for help.
The family, living three hours away, rushed to the scene. By the time they arrived, however, some kind souls had already taken him to the local hospital and admitted him for care.
The next day, he was transferred to a neurology center in Nagpur. The scans revealed the harsh truth: his brain had suffered severe damage, and there was no chance of recovery. Surgery couldn’t revive the neurons that had been lost.
Still, the neurosurgeon did what he could. He removed part of the skull, hoping to relieve the pressure building inside his brain, the only option left to save him—even if it was just to keep him alive.
Three months passed. The family drained all their savings into his care—ICU fees, ventilator charges, antibiotics. But the surgeon gave them the harsh truth: there was nothing more that could be done. He advised them to take him home.
At home, they tried to make him as comfortable as possible. Oxygen flowed steadily through a tube into his nostrils. They turned him regularly to prevent bedsores, massaged his limbs, put drops in his eyes, suctioned his throat, and fed him through a tube. But every day, the same question haunted them: When will he open his eyes? When will he speak? When will he recognize us?
Unable to provide the care he needed, his mother decided to bring him to our hospital. It was near her village, and she had heard that our nurses were kind and approachable.
Today, his sister asked me the same question again. Her small frame trembled with emotion. Her eyes, brimming with tears, spoke of a heart weighed down with fear and sorrow. She fought to hold them back, but the tears spilled down her cheeks. Her voice was barely a whisper, “Why is destiny so cruel?”
As I looked at her, I heard the voice of the grandmother, who had been silent until now. Frail, her face etched with age, her words carried the weight of a lifetime of pain. “I raised him, you know? After his father died, I cared for him and his sister. His mother worked all her life for them, gave them everything she could. Now, when all was supposed to be well—when I hoped to see him married, start a family—this happens. Why am I seeing him like this? Why is this happening to my grandson?”
Her voice cracked, and I saw the depth of her grief in the lines of her face. I was at a loss for words. My residents and the nurses stood quietly by, giving them space to express their pain. We didn’t try to offer advice or console them with empty words. We simply acknowledged their suffering. One of the nurses gently held the grandmother’s hand, showing that she was not just a caregiver, but someone who truly understood their pain. Sometimes, the only thing left to do is listen—and show empathy.
The room fell silent, the weight of grief filling the air.
As we left the patient and continued our rounds, I reflected on the true challenges of caring for such patients. What happens when a family runs out of money, when no caregivers are available at home, when bringing the patient to the hospital becomes impossible? Yet hospitals often send patients like these home with the same answer: “There’s nothing more we can do. Take him home.”
Medical school didn’t teach us how to deal with this. We were trained to diagnose, treat, and move on. But what about the times when the treatment ends, and the real work begins—the work of caring for a life reduced to a fragile shell?
There is no answer, only silence.
Those are facts of life we doctors face. I have had several such patients dying in my hands. We cannot do anything except remaining silent. There remains hardly any difference between the helpless relatives and the doctors. Heart touching experience. May god give us the courage to face such experiences.
So very true!
Indeed a harsh Bitter Truth ! Helpless and Sad!
Prayers are heard is all I know… sarbat ka bhala🙏
Short of words to comment
True sir. And unfortunately we do get so many patients like this. All I say is ” nothing can be done, by anyone and anywhere. Please dont spend any more now in 5th/6th/ Nth opinions, such that the kin have to bear economic loans/losses later
I still remember the first time I faced death with Avita as an intern .. a mother whose teenage son just laid with her and cried .. and again as an intern myself.. a husband just sat next to his wife as she faded away.. both times there was nothing we could do .. i can still remember their faces .. again with my own parents.. the truth that we are only an instrument of God and should never forget that .. empathy and compassion are our most powerful tools .. and it is our job to provide dignity and strength in disease and death to those we treat.. the rest we have been taught well…
Unfortunately not uncommon harsh truth. It may sound culturally inappropriate but sometimes dying with dignity is better that living with false hope. Luckily for us euthanasia has been made legal here few years back. The process is purposely cumbersome. I have had atleast 3 patients with end stage IPF who opted for assisted dying. Of course it requires a high level of health literacy among the population.
No doubt,very harsh truth.Perhaps therefore,the Almighty has taught us to live our lives between “sabr”(patience) and “shukr”(thanking His bounties)….
Once Dr Jajoo was to operate on a guy, & Dr Jajoo asked patients father, that the guy might die, the father refused saying , taking dead body back home wud be expensive.
Dr Jajoo said, all the ethics come to halt in such situations. 🙏
When i see that the patient is in a state of terminal decline and will not come out alive i try to convince the patients relatives to opt for supportive care only. Residents are instructed to keep investigations and medication to a minimum so that patient can pass away without any more financial burden on the family. If the patient is likely to be in a vegetative state we start training the next of kin about care at home and encourage them to buy air mattress , oxygen concentrator etc rather than spend all their resources on a long drawn out futile stay in the hospital. I think it is the doctors responsibility to help the patient make a decision in such situations because in most circumstances the relatives are so distraught and bewildered that they just cant reach a decision by themselves
No words. Only prayers.
We need affordable palliative care centers across. Nagpur had a very good one I remember. Visited in my internship days. Felt the glaring need in my MOship period.
Such one incident that I remember is a couple abandoned their old bed ridden mother and just ran away from their home. Neighbours came to me (as I was the Medical Officer n had helped with few destitutes lying on the road) as stench was coming from the room. Lady was forced to eat her own excreta (Pardon me for gory details). We called up the daughter in law who said do whatever u want, we have exhausted the money n won’t come back.
As she had relatives took time to arrange for some institution to take her as was wary of any action later.
But the lady died a day prior when the organisation was supposed to pick her up….
One thing that never leaves me….
I read what you wrote and thought- Ah, but you did do a lot for that family even when ‘there was nothing more you could do’. You supported the patient and the family, gave them space, listened to them, didn’t do things just because you could, respected their choices and your patient’s dignity. You provided good Palliative care. The goals of care were different, but the team provided care to suit the patient’s needs.
A lot of what you have written in this post Sir around medical school education and training is what I too resonate with. Happy to support any teaching in palliative care ( which happens to be my topic of special interest). I will DM you
Very touching.
Very True.