PERSONAL ESSAY

The Cry That Was Not Mine

In a room where roles dissolved

Photo by Daiga Ellaby on Unsplash

It has been almost 1.5 months since Dr A. was assigned to me as one of the two junior doctors working with me. Both of them are first-year residents.

Dr S. is very sweet, hardworking, and eager to learn. Most of the time, she is the one doing all the work.

Dr A. is a first-year resident too, but S., being a fresh graduate, is more junior, and maybe that is why she wants to learn so eagerly. Fresh graduates are usually more ambitious and have more energy.

Dr A. graduated in the same year as me. She worked in various hospitals in different roles instead of pursuing residency, so you could say she already knows a lot about medicine.

I have been noticing A. for quite some time. Since we are the same age and graduated in the same year, there cannot be the typical senior-junior hierarchy between us, or maybe I cannot form that dynamic because of my own hesitancy. Obviously, S. is far junior, and it feels sensible to treat someone nearly 8–9 years younger as relatively more junior.

I know that A.’s mother passed away almost 2–3 months ago. Her death was sudden due to a cardiac arrest, and initially, for a few weeks, she was obviously on leave in mourning. After she returned from leave, the hospital gave her the oncology rotation to work under me. They are primarily internal medicine residents and don’t need to work in oncology during the first two years. But as the hospital is short-staffed, they sent them to oncology to assist me for a while. They think it is less hectic compared to the other rotations she is supposed to do.

They are considerate enough to let her take a few breaths of relief before coming back into full form.

Mostly, S. and I deal with the patients. Initially, A. was on leave every other day. Some days she had to participate in mourning rituals; other days her siblings were sick, and so on.

Over time, I developed irritability due to her constant leave, lack of interest in ward work, and authoritative attitude. I wished I could find a replacement for her, or talk to HR and tell them I did not need her and that S. alone was enough. To be honest, her presence did not make much difference to me. It was not helping much.

Being the eldest daughter after the loss of her mother, she definitely has a lot of responsibility on her shoulders. She takes care of her siblings in a way I can never imagine. She cooks, cleans, sends them to university, does grocery shopping, and everything else. She is very talkative, and when we arrive in the morning, the first thing she does is tell everyone what she did the previous day, and the memories of her mother. Every conversation lands on the same topic again: her “mama.”

I could not interrupt her and tell her to stop talking about her mama and siblings all day, nor could I say anything harsh to her because she was already going through such a delicate period. Why should I scold someone already struggling?

I had grown sick and tired of hearing everything about her mama, what she liked, what they used to do together, how close they were. Maybe because I am a good listener, I pay too much attention and cannot ignore background conversations even when she is speaking to someone else.

I do not know how other people around me, especially S., effortlessly ignore these things. Maybe people forget easily, while things remain in my mind and keep piling up there until they overwhelm me.

Then I suddenly want to throw that entire pile of thoughts out of my head, and while doing that, a lot of damage gets done.

When I keep treating people kindly and listening endlessly, eventually there comes a day when I explode. My patience runs out, and on that day, all the niceness, politeness, and emotional foundation I built collapses.

A few days back, her younger sister developed enteric fever. She asked me for leave, and I did not want to make things difficult for her, nor did I have the courage to tell her that she had already taken a lot of leave. To avoid conflict, I asked HR for a replacement because S. was already post-call. HR did not give me a replacement and told her she could not take more leave. She thought that I did not understand her, and some friction developed between us. Although I behaved normally afterwards, I noticed that she did not greet me the next day.

Then, for many days, she was mostly on the phone talking to people at home about IV medication administration for her sick sister. It irritated me because physically she was present in the ward, but mentally she was still at home.

Today at 3 PM, when I had to leave, our driver told us that he would pick us up after an hour because the van had a problem and was at the repair shop.

I had to return from the gate back to the on-call room. She was sitting there because she was on call.

Initially, we talked about a patient whom we discharged today. When two doctors talk about ward patients, especially when they are alone after a frustrating and hectic day, after spending the entire day putting on polite, brave faces while interacting with patients and answering attendants’ endless questions, they usually discuss how exhausting the shift was. Which patient was particularly difficult, what could have been done better, and sometimes they even feel grateful when a difficult patient finally leaves.

The patient we were discussing was an elderly lady with acute myeloid leukaemia. She was initially on chemotherapy, but now she has been admitted with sepsis in a very poor condition. It was clear she had a poor prognosis. She was not even alert or oriented and was not fit for anything beyond palliative care.

The day she came, after examining her, I had counselled the son in detail regarding her poor prognosis and limited life expectancy. Although she was one of my most favourite and affectionate patients, and I was already sad at the realisation that soon I would lose the patient who had showered me with love over the past few months, there was also a strange acceptance inside me. Whenever she came for chemotherapy, she used to kiss both of my hands, and this time she was not even recognising me. But sometimes life brings physicians to a point where they are simply ready to say goodbye.

Her son completely understood, and I counselled him that if she deteriorated further, we would suggest against chest compressions or ventilatory support. The son, who had been taking care of her all these months, understood her condition. He agreed to every word I said.

Both S. and A. looked at me with amazement, seeing how patient and composed I was while explaining everything clearly yet compassionately, without using a tone or wording that might seem insensitive. Obviously, that was experience speaking. I still remember the years when discussing limited life expectancy with attendants felt unbearably heavy.

After I left, the patient deteriorated further, and, being the on-call doctor, A. contacted me regarding the management plan. I added the medications and advised her to get the DNR papers signed as a formality. Verbally, everything had already been decided between the son and me, but the signatures were still pending.

She did as I asked. Miraculously, the patient stabilised, improved, and was oriented when I saw her today. But the son wanted to move her to a hospital closer to their home so that arranging things would be easier for them. I discharged her on request, and she was transferred.

A. started telling me that the previous day had been difficult for her. On probing further, she told me that getting the DNR signed, although technically just a signature, had been emotionally very difficult because it reminded her of her mother’s last moments. Her huge kajal-lined eyes brimmed with tears.

Honestly, this was the last kind of conversation I wanted at that moment. I did not have the emotional bandwidth to console her.

I simply wanted to lie down quietly for half an hour. I was eager to leave because I had planned to spend the evening by myself. I had dressed up nicely, I was extremely hungry, and I just wanted to reach my favourite place and order food. That half-hour delay was already making me irritated.

But just to be polite, I listened attentively.

She told me how her mother had suddenly suffered a massive cardiac arrest three months back. Her mother was only 50, had no previous illnesses, and had been fit and healthy. She underwent immediate stent placement, but deteriorated rapidly and ultimately had to be put on ventilatory support. Then she crashed. Everything happened within two days.

The story was heavy, and I was hearing the details for the first time. Her tears were disturbing me deeply. Maybe because I had been hungry all day, emotionally exhausted from the difficult discharge and goodbye to that patient, and now confronted with this constant flow of grief, I could feel my own tears beginning to form.

To change the topic, I asked about her father. Since she was managing everything so flawlessly, I assumed perhaps her father was shattered by grief, which was why she had become so invested in taking care of everyone.

“Uncle, how is he?”

“Don’t ask about him. Everything is okay.”

Before continuing, she made me promise not to tell anyone because she had never shared this with any colleague before. I promised.

She told me that they had been living separately from their father. He had never been interested in her mother or the children. Despite them being such a well-qualified and genuinely wonderful family, I could not understand how someone could leave them.

She told me that he had left them around the time she graduated. He remarried, and since then, she had been the one earning, supporting her mother, and raising her siblings. That was why she could not pursue residency and had to keep working different jobs all these years, simply to earn money.

Then she told me that the second wife had also left her father, and now he was preparing to marry again for the third time, only a short time after the mother of his children had passed away.

I had never realised she was carrying so much suffering. So much pressure. So much responsibility. So much pain hidden behind that talkative, chirpy, cheerful personality.

She told me how she had to remain the strong one the entire time.

By then, my tears were already flowing. I never imagined that I would one day sit crying beside a colleague I did not even particularly like.

She recalled that day how her siblings had become exhausted from staying awake for too long when her mother was in the ICU, so she sent them home. Then her mother deteriorated.

As she narrated the story, I imagined myself standing inside that ICU among the beeping monitors.

She stood beside her while CPR was started. She stayed there and watched the entire resuscitation.

She described the intense CPR that continued for almost 30–40 minutes simply because she could not bring herself to sign the DNR.

In my mind, I was standing there watching everything.

At first, I was silently crying. Then I realised I was sobbing. I could almost feel the ribs breaking under the force of the compressions, all because a daughter was still hoping for a miracle.

I understood then why she could not sign the DNR.

Imagine having to choose between hope and accepting the loss of the only person in the world who truly belongs to you.

I felt something like the cry of a wounded animal escape from my throat. I had never heard such a sound come from myself before.

In reality, I was crying loudly in that room while she sat there shedding tears silently. Her beautiful, big kajal-lined eyes were ruined with tears.

She told me that it was the 9th of June, the third-month anniversary of her mother’s death. Her mother had passed away on March 9th.

I kept imagining how devastating it must have been: losing a mother so suddenly, so young, only 50 years old. Losing the only emotional anchor in her life while already having a constantly absent father. Losing a mother who was also her best friend. Standing beside her during endless CPR.

She hugged me, and my cries became even more intense. It felt as if the loss were personal.

I imagined my own mother. My mother is only 56. Hers was 50.

My sobs turned into loud shrieks of pain. I have never cried like that before, no matter how difficult life had been.

What was happening to me?

She needed comfort, yet it was me crying uncontrollably while hugging a colleague, as though someone close to me had died. As though a doctor had just told me, “Sorry, we could not save your mother.”

My cries became louder and louder. She no longer had words to comfort me. I felt her freeze in my arms after witnessing someone cry with such intensity.

A nurse from the neighbouring ward came running after hearing the noise. She opened the door, thinking someone had died. Usually, when such sounds erupt from a ward, nurses immediately rush to see which patient has passed away.

The nurse kept asking what had happened to me and why I was crying so loudly.

Honestly, I could not even comprehend that those sounds were coming from me. I had never cried like that before.

And in that moment, I realised what attendants must feel when we tell them, “Sorry, we could not save him/her.”

Thirty minutes had passed. People had started calling me because they were waiting for the bus.

I just left.

It was one of the saddest days of my life.

I have decided that while she remains with me in this ward, I will not ask her to obtain DNR signatures from attendants again. I will do that part myself.

Please keep her in your prayers.

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