Originally posted on Facebook, December 15, 2020. Translated August 29, 2026.
“Thank you, doctor. Thank you so much.”
In an elevator where ten strangers stood in awkward silence, a slim, white-haired gentleman in his mid-sixties bowed to me — I was in my early thirties — and wept openly as he said it.
There are moments in life when you feel guilty for not having done everything you could. When the person you failed is someone you love, the guilt is worse.
There was an elderly woman in the neuro ICU. Late eighties, white hair, unconscious. She was so neatly kept that it was easy to imagine how alert she must have been right up until she lost consciousness. The spontaneous intracerebral hemorrhage was massive, and she was already unresponsive when she reached the emergency room. Emergency medicine had sensibly intubated her before I ever saw her.
The bleed was too large. It met the criteria for surgery — cutting through scalp and skull to evacuate the clot. But there was no hope. Surgery would not bring her consciousness back. She was already close to brain dead.
“Family of Mrs. ___?” I called into the waiting room, where dozens of families sat in various states of dread. Four or five middle-aged people shot up and rushed toward me. “Doctor, is our mother all right?”
I had to tell them there was no hope. Honestly, it doesn’t shake me much anymore. I have seen hundreds of patients past saving. But I had a duty to comfort the family in front of me.
“It’s a spontaneous brain hemorrhage. Was she well before this?”
“Yes. She talked fine, ate fine, went for walks.”
When a patient already has dementia, or when the family is estranged, you don’t have to work as hard at the explanation. But from their faces, and from what she had been like before, it was obvious this news was going to break them.
“I don’t enjoy having to say this, but you need to prepare yourselves. The hemorrhage is very severe. Surgery won’t save her. The operation involves cutting open the scalp and skull to remove the clot and relieve the pressure on the brain. But her brain is already too damaged for relieving that pressure to mean anything. If you insist on surgery, I’ll do it. But I don’t recommend it. If she were my family, I would not operate.”
After a long conversation, the four or five of them decided against surgery. She was moved to the neuro ICU and started on medication. We expected her to live about two weeks.
A few days later, in the afternoon, visiting hours had ended. I had finished explaining things to another family and got into the elevator, which was full of visitors. The man standing beside me — mid-sixties, white hair, slim, in a coat — spoke up. “Doctor. I’m Mrs. ___’s son. May I ask you one thing?”
I see too many patients to remember faces. But the name brought back the conversation in the emergency room. Ah — that patient? The one I’d told them not to operate on?
“Of course. What would you like to know?”
He couldn’t get it out right away. His face flushed a deep red. Then he said it.
“Was it really right not to operate on my mother? Shouldn’t we have done everything to the very end — shouldn’t we have done the surgery?”
This man was carrying guilt. Enormous guilt. That he had failed to do everything possible while sending his mother away. To me she was an unconscious patient. To him she was not. She was the young woman of her twenties and thirties who nursed him, who ate with him and laughed with him and took him on outings, who loved him as her son. And he was letting her go without so much as attempting surgery.
With a family member like this, you have to be blunt. You must never say that surgery was an option. His face was already red with guilt, and any opening would only deepen it. The answer has to be flat. Sharp, even a little cold.
“Sir. You remember what I explained in the emergency room, don’t you? Your mother should not have been operated on. Why would you even ask that? Why would we operate?”
Even I was startled by my own words. Was that too harsh? Would he be angry? But his reaction told me I needn’t have worried.
His flushed face went redder still, and tears gathered in his surprisingly large eyes. They spilled over almost immediately and ran down in thick streams. His voice caught as he answered.
“Doctor. Thank you. Thank you so much.”
I had cut the guilt out of him. In that small elevator packed with more than ten people, he bowed again and again to a man half his age, thanking me. Embarrassed, I bowed back. I hoped my explanation had been some small comfort.
She died a week later. I was off duty that day, and the second-year resident pronounced her. I wasn’t there at the end, so I never saw him again.
A note on the translation: in the Korean original, the patient is referred to throughout as halmeoni — grandmother — a word Korean speakers use for any elderly woman, not only their own. English has no equivalent, so she appears here simply as a patient. Something is lost: in Korean, the doctor is already calling her by a family word while insisting she is not family.
All posts on this site are written by Jiyong Iruon Park.