08/06/2026
"The Phone Call that Taught Me How To Grieve,"
Written by Bishal Gyawali, MD, PhD, shared with CaringMatters by one of our caregiver grief support group facilitators, Susan Eisen.
Mike (name changed) was one of my favorite patients. We aren’t supposed to have favorites, but we are human. And sometimes you just have that unexplainable bond with someone.
Mike was 65 when he died in late June. He had metastatic colorectal cancer that had spread to his liver, lungs, and peritoneum.
I met Mike for the first time 2 years ago. I explained in our first visit that his cancer wasn’t curable.
He was well-educated and optimistic, though he was not a “fighter” (I think that metaphor does more harm than good, anyway). When I offered to provide more details about his prognosis, he said he didn’t need or want that information. He wanted to live his life to the fullest without making cancer the focal point.
The only treatment-related question he ever asked me was if he’d be eligible for immunotherapy (he was not). Otherwise, he completely trusted me to make the best decisions for him.
His wife, Jess, was very supportive. She accompanied him to every visit. Although she might have wanted more information about Mike’s prognosis, she respected his decision.
Mike and I shared a special bond that went beyond patient-doctor relationships. I treated his cancer, but I also cared for him. We talked about our vacation and travel plans; we joked around and teased each other. He told me about his life: his love of horses, sailing, and traveling in his RV, which he was quite proud of.
He prioritized living his best life over the longest possible life. So, we arranged several treatment breaks to allow his travels. During those breaks, I offered to make phone appointments to save him the trouble of coming to the cancer center. But he always insisted on seeing me in person. “It’s no trouble. Even if there is nothing to do, I just want to see your face,” he would say.
We had become so close that just seeing his name on the list of my patients for that day would bring a smile to my face.
After progressing on two lines of chemotherapy, his functional status had declined. He opted not to try chemotherapy for a third time to avoid the side effects of treatment. Ascites became the biggest nuisance towards the end of his life. I was thankful that he had an excellent palliative care team.
When Jess brought him to the ER on a Saturday morning late June, she just wanted to make sure he was okay after a fall. They had dinner reservations that night. After a few hours in the ER, when they were asked about their intent regarding resuscitation and intubation, the first reaction was, “That means we won’t make it for dinner tonight?”
Mike passed away the next day. Thankfully, peacefully, and not with any pain. Jess was with him the whole time.
I wasn’t in the hospital when this happened. When I returned from my travels, I learned that Mike had passed away. It was heartbreaking for me. I loved him.
Throughout his care, he had been adamant about not having conversations about his prognosis, and I respected those wishes but also wished I had been better able to prepare him and Jess for this moment.
When I picked up the phone to call his wife, I had butterflies in my stomach. These calls never get easier.
I asked: “Hello, is this Jess? I am Dr Gyawali from the cancer center.”
“Thank you for calling,” she responded, her voice cracking a little.
I told her that I knew Mike had passed away. She recounted that day with me. She acknowledged my many efforts to talk to Mike about his prognosis but also knew he wished to live the remainder of his life without the burden of that knowledge. I told her that Mike was one of my favorite patients, that I loved him.
She said, “You know, Mike could easily pay to get treated at one of the top cancer centers in the world. But he chose to get treated in Kingston because he liked you and your team here.”
As I was getting ready to put the phone down, Jess said, “I’m sorry for your loss, too, Doctor. I know how much he meant to you. I’m happy you were his oncologist. Please take care of yourself, too.”
I hung up the phone and cried. For a while.
“I am sorry for your loss.” It was the first time a patient’s family told this phrase to me. Of course, it is my loss too. I had never thought of it this way, perhaps I thought I was not allowed to think of it this way. But it is. And this acknowledgment felt like an important step in my own healing. And her final sentence: “Please take care of yourself, too.”
How often we forget to acknowledge that. You can participate in dozens of wellness trainings and seminars your institution throws at you, but unless you acknowledge this vulnerability in yourself and stop pretending that these losses don’t affect you personally, you are not letting yourself grieve properly. You owe it to yourself and your future patients to grieve for your loss, and take care of yourself.
Immediately after that phone call, I sent a text to some of my trainees: “If your patient dies, always call their family. Always. No exception.”
Then I sat down to write this blog.
This is how I grieve.
