“You will die soon, maybe even before the weekend. Dad, are you scared?” I questioned.
“No! Why would I be scared? There’s nothing to be scared about. I have a strong spirit, and nobody knows what will happen after I die,” declared my father on an early spring Tuesday afternoon. The new season did not bring renewed energy and hope. My father had endured a tortuous winter with four hospitalizations ultimately leading to multi-organ complications. On his final days in an intensive care unit bed, he missed home, was drained of blood from never-ending needles, had a poor appetite, became short of breath from minimal movement and even had developed hospital delirium with bouts of shrieking, cursing and thrashing.
In just a matter of five weeks, his body had broken down, and there were no signs of recovery. Ominous thoughts haunted me throughout that his death was coming soon, but I was reassured by physicians to just be his son and not think and plan like a physician.
Separating being a physician and his son were impossible. To my benefit, he was hospitalized where I work. I knew the members of the medical team and trusted them. They took care of him like their own. Even in a delirious state, my father beamed with pride knowing his physician sons were advocating for him.
Broken and exhausted with muscle wasting, dependent on others and in agony, he was suffering. “Just get me home. There is no treatment or recovery. I cannot live like this.” My family and I were stunned but listened to his dramatic declaration and desire to focus on the end of life. It was the most lucid he had been in weeks.
We went through all the motions of family meetings and conversations, including with the medical team, to ensure he and we were on the same page. There was a huge part of me that did not want him to “give up.” After all, he raised me to be a fighter. But, truth be told, I also felt relief knowing his suffering would end.
He sternly asserted that “I have seen everything. Your brother and you are doctors. You’re married. I have beautiful grandchildren. Your mom has recovered from her stroke and is OK. I’m at peace. What more do I want? I’m tired. Let me go.”
As much as I tried to hide my devastation and fear that my dad was going to die, I choked up as tears filled my eyes. “We are going to miss you so much. You’re everything to us. How are my kids going to handle not having their grandfather nearby?” I questioned while sobbing.
“Of course you will miss me. It will take you guys six months or so to get used to it,” he confidently reassured me. “I know what I’m doing. Don’t let anyone change my decision.”
He had farewell conversations with family and friends. He was our patriarch, and we would follow his orders. He wanted our mother to stay in their house, as it was perfect for her; to not cremate him in his best suit; and to place obituaries in a few specific newspapers around Georgia where he had businesses and friends.
There, again, in front of me was my strong-willed father. And it became crystal clear to me. He wasn’t “giving up.” He was being practical. He was listening to his body. His fight now was not to survive longer by taking more medications but to die peacefully. Though he was tearful and sad as we cried with him, he was never once regretful.
I woke up feeling nauseated, anxious and in a fog on that Wednesday when his care would turn to comfort only. Knowing my father would die later that day was surreal and unfathomable. The only silver lining was the peace I felt from his strength and courage.
As much as he wanted to spend his last moments at home, he accepted that his oxygen requirement was too high to leave the hospital. In his final conscious moments, we hugged him, kissed him and told him we love him and were grateful for him. He devoured two vanilla ice cream cups before the sedating medications began working. He smiled as he dozed off peacefully. My mother, brother and I sat at his bedside for hours — until his last breath.
My father has taught me that death is not defeat. His story reminded me of what it means to truly listen to and align with a patient’s wishes. He showed me how fear at the end of life can be combined with peace, comfort and acceptance. I now share my father’s story with patients and families. His powerful legacy carries on with me daily.
I always knew that he made me a better husband and father by teaching me how to love and be loved, but it’s clear his final lesson was also to help me become a better physician.
Dhaval Desai, the author of “Burning Out on the Covid Front Lines: A Doctor’s Memoir of Fatherhood, Race and Perseverance in the Pandemic,” is director of hospital medicine at Emory Saint Joseph’s Hospital.
About the Author
