Alternate Reality

I meet Paul on a 28-hour ICU shift. He displays his dimpled smile like a badge of honor even though his curly hair sticking to his forehead, his darker-than-usual hospital gown, and his sunken brown eyes tell me that his struggle with complications of esophageal cancer have been vast. Something about Paul’s spirit rewinds the clock.

I am once again a third-year medical student. The past couple of months float like vignettes through my mind as the doctor tells me about the mass on Dad’s endoscopy – the progressive inability to swallow liquids then solids, the pounds melting from his body. The simple boards question that I failed, or refused, to recognize. Gina, Paul’s wife, tells me that this is how his esophageal cancer was discovered too, by surprise to no one except his own family, exchanging playful laughter for morbid conversations about what comes next.

I reexperience vignettes – the horrible retching sounds from my parent’s bathroom in the middle of the night, the tube feeds that replace Dad’s favorite puri and bataka-nu-shaak, the smile he gives me on my residency match day as he lays on the couch waxing and waning into sleep, utterly exhausted by the chemicals used to “save” him. I watch Paul’s family at his bedside understanding that they too will hold such memories of their father, uncle, and spouse.

Over the last 48 hours of Paul’s life, I remember Dad’s eight-hour-long esophagectomy. He walks around the ICU the next morning with physical therapy with four chest tubes. As each of Dad’s chest tubes comes out, he starts to look more like himself. It is months before the cautious exhale, when the scans remain cancer free, when the feeding tube comes out, and when the chemotherapy port is removed. His hair regrows. Fat reaccumulates on his cheeks and his temples.

In contrast, Paul’s illness progresses. I sit down with his wife and daughter, seeing Mom and myself in them. We hold hands. They tell me that Paul’s spirit is falsely cloaked in a body that does not look like his anymore. They say he is ready to let go. When his family returns to his room, Paul says, “Don’t cry. I’m okay.” We unhook him from the wires, tubes, and machines. We dress him in his own clothes.

He dies later that night, his family around him. I cry knowing that he is living Dad’s alternate reality.

Dimpi Patel
Boston, Massachusetts