Human Remains
Haruna Choijilsuren
They say that grief is like butter in a pastry, heavy and solid, until it gets folded in, and gently flavoring our experiences. Unfortunately, I have never made pastries before.
Instead, I would argue that grief is the cold gust of wind encircling you on a winter New England day. The chill travels through every layer, biting your cheeks and fingertips, leaving you yearning for the warmth of home, of your grandmother’s vegetable soup. Then, once you are back inside, you cannot seem to warm up despite all the blankets you layer on yourself and hot tea you drink. The cold having seeped into every crevice and corner of your body, of your existence.
Grief is an ocean that surrounds you, endless for miles and unrelenting. Leaving you without a compass, a shaky raft withering apart in a sky without stars. Unfortunately, you never learned how to swim, fearful of the deep and dark ocean.
Grief is to cry violently without a reason. Tears streaming uncontrollably as you look through their clothes, their books, their random scribbles, and the folded wads of candy wrappers. Midday sobs, shaking your body as you wade through your life. Not wanting to accept the new “normal.” It is crying half a year later, before you leave the house for an important event. And they thought that three-to-five business days would be enough.
Grief is meeting the characters of their stories—the neighbors who shared saplings of corn, the relatives they loved as their own children, filling in when their parents passed, and the friends who had traveled together through blizzards and sandstorms. Their faces red and splotchy as they are unable to stop crying. A village of people, filled with stories and memories, devastated but held together by threads of love and compassion. Wholly unprepared for the life ahead.
Grief is discovering more of the person through their belongings. The headshots of beloved grandchildren tucked away in between pages of a book. Old crumpled masks from the COVID-19 pandemic. Dried out wet wipes from airlines, saved for a day in the future. Half-eaten rolls of candy for when their blood sugar drops. Faded photographs from half a century ago, friend-turned-coworkers squinting in the sun. Notebooks filled with scribbles, with sentences crossed out, and unfinished thoughts trailing away. Dead batteries forgotten in faded boxes alongside unopened packages. Collections of Nokia chargers, Blackberry batteries, frayed wires, and iPhone cords—decades of technological advancement in one. Tidbits of paperclips and screws were squirreled away for the day their granddaughter asks for one. Names and numbers of old friends, unable to erase the ones who have left already. Notebooks started but unfinished, and now they never will be. Plans created but to gather dust, to be left for a lifetime of “what ifs”. Even through their belongings we see how they cherished living. How much they loved their spouse, their kids, and their grandchildren.
How little did we know of their limited time.
Back in the anatomy lab, we meet our donors.
Donor ID. Age. Cause of death. Occupation. Smoking status. Yes or no questions.
All that is left of the person.
It is cold and sterile, with the fluorescent lights humming above as the bags are unzipped. As you hold their head and adjust their arms, you see decades of swimming on the beach and hiking along the coast. You see scars that hold stories you will never know, perhaps from finishing a marathon or putting up holiday lights.
You try not to envision your loved one’s face in the place of this person. This cadaver?
Who loved this person?
What was their favorite food?
What is the story behind that scar?
What did they enjoy about their job?
What made them get up every day?
Did the doctors who attempted resuscitation wonder about us, the family, as they picked up the phone?
What did the morgue staff think about as they took out sheets and wrapped him to go home for the last time?
Back in the hospital, I see my grandfather every day. He is the patient that excitedly shares their notebook filled with their blood pressure, blood sugar, and insulin logs, managing their type 2 diabetes. I see him in the patients whose wounds heal slowly, worrying their families and their physicians. Every wince etched across their faces, and groans of pain they struggle to hold back, I remember my grandfather. I remember the cut on his thumb swelling and oozing as he worked in the garage, refusing to heal. I remember the pain and anger from the persistent muscle cramps, restraining him so he had to lay on the ground—far from the man who biked five miles every day. I also see him in the patients who hesitate to ask questions—nervous that they will not understand their physicians, or that their question may seem “childish” or “ignorant”.
Months after the three-to-five business days, I now ask my patients what I wish I could ask my grandfather. “How is your pain, are you doing okay?” “How is your normal range of motion, are you having difficulty with anything?” “Do you have enough insulin; do you need help getting resources?” “Do you have any questions for me, anything I can help with?” I reassure them to the best of my abilities, explaining concepts when I can and listening to their worries and stories. I take their blood pressure and inspect their wounds, just as I did once before. I absorb all that I can, caring for patients with the same compassion I had for my grandfather. Hoping to be the doctor he needed in his final moments.
The grief remains, and the sobs still come forcefully.
“But the butter remains, hitting us in unexpected and powerful ways. We taste it all and grapple with its complexity…the heavy and the lovely, is precisely what makes life so full…”
I should learn to bake pastries.
Haruna Choijilsuren is a second year MD/PhD student at UMass Chan Medical School and a graduate of the Medicine, Science, and the Humanities program at the Johns Hopkins University. Her interests span narratives in medicine and the human experience.
