While writing my peace “To Speak,” I was struck by how difficult it is to talk about the process of dying with patients. So much is unknown, and frightening. I had no answers for my patient when she asked me what her death would be like. I am grateful for resources like the hospice movement, which provide more space and vocabulary for these kinds of conversations. I hope I would have a better discussion with my patient now than I did when she asked me her questions so many years ago.
I am moved by the comic panel in the Spring 2019 Intima titled “A Death In Chicago, 1972: Elizabeth Kubler-Ross and my Family,” by Pat Arnow. What an incredible insight into starting to learn to be present for the act of dying. The piece shows us how each person’s unique experience informs the idea of how they want to die. The narrator feels so unprepared and unqualified to help her father, but still, it means so much to him that she tries. Even if she can’t manage to give him his injections, she is there with him. Witnessing his illness makes her—as it might for any of us— feel frailer too. I love the panel where she sits with her dad on the floor quietly holding hands.
The first page in a graphic medicine narrative by Pat Arnow, who is a photographer, writer and cartoonist in New York. Download a PDF of it here.
A full six panels at the comic’s end are devoted to her father’s eyes. There’s so much life in them. And then suddenly there’s only darkness in the dilated pupil, and he’s gone. It’s scary how final that is.
It is the great privilege of medicine that we are asked to show up, constantly, albeit in a different role than a family member would be. To not look away is in the fabric of what we do. It is partly why the practice of medicine can be exhausting, electronic charting and reimbursement quibbles aside. We are asked as caregivers not to dispense always but to receive, to hear questions that we don’t want to reflect upon. It is our privilege to be present.
Krishna Chaganti is an associate professor of rheumatology at UCSF Medical Center. Chaganti has been writing short creative essays for several years as a way of understanding her interactions with patients and examining things that happen in her non-medical life too. Her Field Notes essay, “To Speak” appeared in the Spring 2024 Intima: A Journal of Narrative Medicine