My grandmother on my father’s side passed away on Sunday. She was my last remaining grandparent and had been diagnosed with kidney cancer with metastases to the lungs. The amazing thing was that she was diagnosed more than three years ago, and she beat all of the odds and continued living, treated with new drugs on the market such as mTOR inhibitors. She was a living miracle, and the fact that she survived beyond any of our expectations is something I cannot explain from a medical perspective.
I haven’t spent much time with my grandmother in recent years since life got busy with college, medical school, and my recent move to New York. I remember a small thin woman standing at around 4’10” tall wearing a beanie cap and a traditional Chinese 棉袄 mian ao, a cotton women’s jacket, black cotton pants and shoes, bustling around in the kitchen making sure all the grandchildren had enough to eat. I remember her taking care of my grandfather and waiting on him hand and foot pretty much right up until the moment he passed away when I was 15 years old. I remember her toothy smile that lit up her face and how she never complained even though life was hard (can you imagine raising eight children and then moving to a foreign country where you don’t speak a word of English?). I remember going with her to a doctor’s appointment to see her oncologist Dr. Pal at City of Hope and thinking, “There’s nothing I can help with here; this medicine is way beyond me.” And I remember last year at my wedding when she greeted me with a huge smile of congratulations even though her body was so frail and weak she needed a wheelchair to get around.
There’s a lot of thoughts going around in my head right now but one of them is how thankful I am to be in medicine because I can help act as a liaison between the doctors and my family members. I don’t know very much about renal cell cancer and I know even less about the new immunotherapies that have come to market since I graduated from medical school. But what I do know is the importance of a goals of care discussion and when further life prolonging actions no longer provide any benefit. Coming from a medical background, I can also speak to other physicians involved with my grandmother’s care on a deeper level, and I’ve found that every interaction with a physician in which I’m coming from the patient perspective teaches me so much about how to be a better physician. I am so appreciative of my grandmother’s oncologist Dr. Pal, who not only is a child prodigy who entered UCLA medical school at the age of 17, but also took the time to visit my grandmother in her home on Saturday when she started decompensating. Dr. Pal took the time to call me and update me and my family members every step of her hospitalization and again when her breaths became agonal and we transitioned to comfort care. I can honestly say that I’ve never had the type of doctor-patient relationship he has formed with my grandmother over the last few years, and that I can only aspire to be the type of physician he is one day.
Last night after hearing the news of my grandmother’s passing, I pulled up a college admissions essay I wrote about her back when I was 18 years old, over a decade ago. I reread it and even though I haven’t been physically near her in a while, I feel closer to her as I’m reminded of all the ways she has inspired me through the years. I wanted to share a portion of it with you today.
The dashing war hero rode through a small Chinese village he had liberated from the enemy, crowds of villagers rushing out to meet him. He looked through the throng of people and spotted a beautiful teenage girl. The forty-year old general, overcome with emotion and greed, walked over and asked her to marry him. To his surprise, she refused, explaining that she had ailing parents to take care of. The general was undeterred and sent soldiers to her home, demanding her hand in marriage. The young maiden hid in the mountains, but eventually her parents caved into his wishes, unable to refuse someone of such high stature. The next day, the girl and the general were wed. The seventeen-year-old bride packed up her belongings and left with her new husband, not knowing when she would see her family again.
The world turned upside-down for my grandmother after she got married, but her courage sustained her through all her hardships. She never had friends or family around; she barely even got to see her husband because he was always busy. I asked her how she survived being uprooted from a small village and transplanted into Shanghai, a foreign environment, and she replied that one must adapt to survive. Even after my grandfather’s death, marking the disappearance of the only husband and father figure she had known for sixty years, she stayed strong and learned to live without him. She found new hobbies, made new friends, and finally completed her dream garden she always wanted. From my grandmother’s example I have learned that resilience is the key to survival; no matter what happens, I should always rise to the challenge because every obstacle, when met with courage, can be overcome.
I have not seen my grandmother recently, but I know she is doing well; after all, she is keeping herself busy learning new things and traveling to each of her eight sons’ and daughters’ houses in America, Canada, and Taiwan. From being a poor farmer’s daughter in China to a famous war hero’s wife to a widow in a foreign country, this amazing woman has used her adaptability and love of knowledge to get by. I feel so lucky to have gotten the chance to learn from someone as brave and wise as my grandmother.