On a Friday afternoon, oncologist Ranjana Srivastava is called to the bedside of a man in his early 70s who has deteriorated after major cancer surgery two weeks ago. Instead of the expected recovery, he now has dismal blood pressure and failing kidneys. The surface questions involve fitness for chemotherapy and dialysis options, but the underlying request is clear: specify that he is dying.
Unexpected presence of a grandson
At the bedside, Srivastava initially assumes a lanky man is the patient's son, but he reveals he is the grandson, no older than 20. The patient does not speak English, adding to the difficulty. The grandson texts his mother, and a FaceTime call is arranged with four family members. The patient shows no interest, so Srivastava moves to the edge of the room.
She explains that the operation was not intended as a cure but to reduce the tumor burden, and that the aggressive disease does not respond well to chemotherapy, which often causes toxicity. Now, chemotherapy is academic, and she guides them through next steps. The patient's daughter says she learned more in those few lines than in previous consultations.
Family's ordeal and prognosis
The family had called an ambulance three times in three weeks, feeling helpless. The daughter concludes the prognosis is grim and sees no point in keeping him in hospital. Her brother asks if their father will live weeks or months. Srivastava says to hope for months but prepare for weeks. The family exhales, and she looks up to see the grandson holding his grandfather's hand and crying.
He wipes his face with a soggy tissue, a picture of bewilderment, love, and mourning. Srivastava touches his hand and says, 'I am sorry you were all alone; you are very brave.' He sniffles but has no questions, just wants his mother. She departs.
The rarity of young visitors in hospitals
Reflecting later, Srivastava notes that a colleague observed how rare it is to see young visitors in hospitals. The medicalisation of ageing has moved infirmity and dying into professional institutions, making youth regard hospitals as restricted zones. Parents often spare children from trauma, but this avoids the realities of physical and cognitive decline. In a digital culture that glorifies appearance, the hospital forces a reckoning with incapacity, vulnerability, and co-dependency.
When youth are spared the realities of death and dying, their innocence is prolonged, but the struggle to reconcile with these issues is postponed to middle age. A lack of coping mechanisms becomes hard to make up for when a major health crisis strikes.
Moral injury to healthcare workers
Srivastava also highlights the moral injury to doctors and nurses who become surrogate families for lonely patients, adding emotional burden to an already strained profession. She admires the grandson's courage and forbearance, and salutes his parents for entrusting him with a difficult task. She hopes more people will think about how to carefully but deliberately expose youth to the realities of life and death that all must eventually face.
