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Medical Humanities

Just Like Me

Solmaz Ehteshami-Afshar
Published June 7, 2020

My patient’s body was draped with a black and red blanket, the blanket given to lonely patients with no visitors. I stared at his pale, still face and white, dishevelled hair. The monitor showed a flat line. A nurse was disconnecting the wires and lines. My senior resident was whispering instructions: listen to his heart for one minute, check for breath sounds, shine the light into his eyes. Once I did those things, I could pronounce him dead. 

I had never done this before. 

I could hear my resident’s voice, but I felt as if I were underwater.

“Solmaz!” Her voice brought me rushing back to the surface. I spoke the words that I had never said: “Time of death: 5:45 pm”.


My patient was an immigrant. Not an undocumented immigrant with insurance problems, not a new immigrant with unknown past medical history, not a newcomer who didn’t speak English, he was just an immigrant, like me, who perhaps decided to immigrate with the hope of having better future. He was also one of those unlucky people who came to the hospital for a minor procedure and ended up with multiple organ failure. A simple, minor procedure – he should have been in and out within a day. I wondered if at the time he was signing the consent he imagined that one of those unlikely complications would end up as his cause of death.  


He had moved to the US more than 30 years earlier, when he was about my age; he had gone to school, built a career, had a social circle, lived a life. Yet for whatever reason, now he was alone. I was told that he had no family members in the US. But he did have extended family back in his country of origin, and before he was intubated he asked the team to update them using Facebook messenger on his tablet computer. I had already spoken a couple of times via Messenger to his niece’s husband, who spoke the best English and always wanted to confer with the rest of the family before making any decision. The last time we communicated, the issue was whether it was time for comfort care. We thought it was. They thought it wasn’t.  


I met this patient a few days before his death.  He was lying on the bed, barely able to open his eyes, his face toward the tablet propped next to the bed. Hundreds of questions came into my head. I felt overwhelmed and sad, not only for him but also for myself and other immigrants, who not only go through the challenge of the immigration journey but also must deal with loneliness while rules and policies keep making it harder and harder for families to reunite.  

I was witnessing the last pages of his life story. All I knew about him was that he was an immigrant who had spent most of his life here. What were his dreams when he first arrived here thirty years ago? Did he think, like I had, that coming here would lead to a better life? What had it been like to leave home? Did he get homesick? How did he deal with the loneliness? 

It suddenly hit me: I could be that person lying in the bed, far from my family and loved ones. Dying alone. All the questions I had when I decided to immigrate rushed back into my head, like a sealed chest suddenly broke open. Is it worth it? Am I strong enough? Can I make it? What will my future look like? Can my loved ones be at my deathbed? Where will my partner be? Can I be close to my parents if they need me? What if my nieces and nephew need me? There were so many what ifs. 


I had to stop the flow of my thoughts so I could update his family. On the other side of the world it was almost 2 am. I wondered if I should wait until the sun rose there but decided against it. I picked up his tablet and clicked on the Facebook messenger audio call icon. The now familiar voice of the patient’s niece’s husband answered. His voice was deeper than usual, his words thick with sleep yet shaky, as if he knew what was coming. 

   I cut the greeting short and told him that he had died. I didn’t know what else to add. Should I have said, “peacefully”? Surrounded by whom? In a room full of medical equipment? A rush of emotions tightened my throat. To my relief, he ended the call so he could update the family and plan the funeral, leaving me alone with my thoughts.    


My mind went back and forth between the day I decided to immigrate and the day someone would be pronouncing me dead. The vastness that exists between now and then, between here and there. Who is going to be there for me? Who will they call? What will be my instructions? 


The tablet made a soft beeping noise and I answered. The ashes should be sent to his family, to the country where he immigrated from, where his life story had begun. They were not certain if that was his real wish or not. I ended the call and got back to fill out the death certificate while still wondering where I would consider home. Where would I want to be buried after a lifetime here?  

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