Dichotomous Endings: A Physician’s Personal Reflection

My grandfather was the patriarch of his family, at the center of a tightknit Lebanese immigrant community in Toronto, Canada. Some of my warmest childhood memories are from Sundays at my grandparents’ home, where there was always family, community, and delicious food. Both in their mid-seventies, they remained exceptionally active and maintained an impressive social calendar. From my perspective as barely a teenager, it somehow seemed that family life would go on forever in this way. So, it is not surprising that I remember vividly when my grandfather first became ill. He had learned from his doctor that his kidneys were failing, and soon after his diagnosis he required dialysis. His warm and full cheeks began to sink as he lost weight over the ensuing months. Visits to the doctor and hospital became more frequent. He struggled to attend family events. One day, he was feeling unwell, and was admitted to the hospital. After a few days, I remember sitting in the hospital lobby with my family. A “Code Blue” was called overhead, and we soon learned what we most feared: his heart had stopped beating and that doctors were trying to resuscitate him. Ultimately, they were unsuccessful.

Now many years later, I have led countless resuscitations as a critical care physician. The patient’s room is filled with a coordinated team working for a solitary goal of restoring life. However, this comes at a cost of broken ribs from cardiopulmonary resuscitation, large and uncomfortable intravenous lines, and generally (but not always) a lack of presence of family members in the room. I sometimes reflect on what my grandfather’s last moments were like. A man who had lived his life surrounded by family died surrounded by strangers.

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