Confessions of an Intern

Week Twenty-seven

This week is important for many reasons. It marks the half-way point in my intern year of residency; rings in the New Year; holds the day I lost my grandmother, Dorothy Millikan; and the lost week of OB training I was supposed to have.

Priorities have a funny way of becoming muddled. Family first for me, I would say in a heart-beat, but I regretfully have had to weigh my responsibilities as a new physician against being more available for my family. I am so glad I spent the whole day with my Grandma at the beginning of December. When they called, I went. My co-workers pulled together and covered for me and I was pleasantly surprised by spending what the nursing home told me was one of my grandmother's better days with her. We visited, told each other we loved one another, shared special moments where I ran my fingers through her thin hair and was near. I watched, heartbroken, as I fed her and most of the nourishment fell from her mouth. At that time she had lost twenty pounds in 2 months, something that tells me as a physician, she is doing poorly. I stayed with her until she was ready for her evening routine before bed and she let me go, without calling me back over and over like in times past. I kissed her cheek and hugged her, and felt it was likely the last time I would see her. I live about 6 hours away.

I looked at her health realistically, with what I know and tried to talk to my family about hospice for her and they said they would talk about it. A week later, I found out the doctor had diagnosed her with T-cell Leukemia. It is rare and four subtypes. We really did not find out which grandma had. My aunt asked all the grandchildren to write to her and share special memories of our time together. I got to it as fast as I could, and they read it to her on Christmas. On December 30, my aunt called me from my grandmother's room, as the nursing home had called them in, concerned she would pass soon. She had been bleeding a lot, and my grandmother had always refused blood transfusions. I was frustrated when I learned that hospice had not been called, and that my aunt and mother had even continued to not make her a DNR until the nurses gave the options: DNR or hospital. My grandmother refused the hospital and consented to the DNR. Thankfully, that night, I had been able to talk to her, told her I loved her and despite her voice being croaky and barely recognizable, I heard her say 'I love you' and 'I need Regan'. That will be the hardest thing for me to overcome...She said she needed me and I was unable to go to her. It was snowing, she was 6 hours away, and I likely would not have made it in time. My mom had come to visit us, so she did not make it to see her mother at the end, but it is probably best.

On the morning of the 31st, my husband and I went grocery shopping, as a good snow storm was blowing in. In the parking lot, there was a frail old man who had visibly had a stroke, holding his left arm the same way my grandmother did, and walking with a stiff left leg. He had parked and was walking in and I noticed he had a flat tire. I insisted that my husband help me if the man would let us, so we changed his tire in the soaking snow, and the elderly man went on his way, hopefully safer. When I got home, my phone rang, and while we were doing what my grandmother would have done, she had passed away peacefully in her sleep.

The whole week, I felt numb. I knew she was in a better place, that her world weary body had suffered enough after having a severe stroke ten years earlier, surviving colon cancer and the subsequent issues related to that, a seizure disorder and being put on psych meds because she was who she was. I choose to remember the vibrant woman I grew up knowing, her laugh, and her persistence. She was a tough lady and could send the most scathing and hurtful letters. But in the end, she and I had come to a truce. She recognized that same persistence in me. She was one of my biggest champions to become a doctor. I would say the only one whole heartedly behind me on my mom's side.

Needless to say, I had a couple of days off for the funeral services, which were small, but beautiful. I was not scheduled on the holidays, so I only worked two days last week. Missed opportunities for learning, but I would not trade the time with my family, no matter how dysfunctional. I only regret not seeing my step grandmother. She is a sad story for another time, ravaged by Alzheimers. She does not remember who any of us are. Who am I hurting by seeing her or not seeing her. In the end, I think it will always be me. She is content believing she is a young girl in the Philippines, being cared for by her papa's servants.