On a Friday afternoon, oncologist Ranjana Srivastava is called to assess 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 are about chemotherapy and dialysis, but the underlying request is for clarity: he is dying.
A Difficult Conversation Unfolds
At the bedside, Srivastava assumes a lanky man is the patient's son, but he reveals he is the grandson, no older than 20. The patient, who does not speak English, opens his eyes briefly, reports pain, and closes them again. The grandson texts his mother, and Srivastava is handed a phone with a split-screen FaceTime call for the family meeting.
She explains that the operation was not intended as a cure but to reduce the tumor burden, with chemotherapy planned for the rest. However, the aggressive disease does not respond well to chemotherapy, which often causes severe toxicity. Now, chemotherapy is academic, and she must guide them through next steps.
Family's Helplessness and Gratitude
The patient's daughter says that in a few lines, Srivastava has told them more than they ever knew or were advised to think about. Over three weeks, the family called an ambulance three times, describing utter helplessness. They were told to wait for the oncologist, but waiting became impossible. 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 gently says to hope for months but prepare for weeks.
The family exhales, and Srivastava looks up from the screen to see the grandson holding his grandfather's hand and crying, wiping his face with a soggy tissue. It is a picture of bewilderment, love, and mourning.
The Impact on the Young
Srivastava reflects on her own son of similar age, whose hardest decisions should not involve the finitude of life. She touches the grandson's hand and says, “I am sorry you were all alone; you are very brave.” He sniffles, and she leaves him to his mother.
A colleague observes 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. Well-meaning parents spare children trauma, but this avoids the realities of physical and cognitive decline. In a digital culture that glorifies youth, the hospital forces a reckoning with incapacity and vulnerability.
When youth are spared a window into the indignities of ageing and the reality of death, their innocence is prolonged, but the struggle to reconcile with these issues is postponed to middle age. The avoidance of illness does not erase it. When people first face a major health crisis, it becomes an existential crisis, and a lack of coping mechanisms is hard to make up for.
A Call for Inclusion
Srivastava notes that doctors and nurses often 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.
