Picture of Arnav AgarwalArnav Agarwal is an Internal Medicine Resident (R1) at the University of Toronto. Check back the last Thursday of each month for a new featured piece as part of his series (Doc Talks: Reflections to Reality)!


We are challenged to embrace frailty and a disarray between mind and body when we encounter patients at the end of their life. As we seek to nurture a place of comfort and wholeness for them, we are tested to bear witness to their helplessness, to appreciate their intrinsic values not only as patients but also as people, and to preserve their dignity. Moreover, we are presented with an opportunity to appreciate the internal struggle of their loved ones as they are confronted with a disconnect between the person they have known and loved, and the patient we provide care for in times of declining health.

Penned based on the reflections of numerous families I met on the wards, this piece strives to give a voice to the struggles many encounter alongside their loved ones in the end of life.


Our voices echoing

through the resilient walls of busy patient rooms—

falling upon a deafening silence around her.


Eyes staring blankly into darkness,

her legs lay tangled into a formless disarray.

Her mouth hung open, yet she was rendered speechless,

as if words had been conceived, only to be forcefully left unspoken.


Her body and brain were together in space —

But they lay truly separated, minds apart.


Wrinkled skin lying on tired bones,

veiling emptiness, nothingness —

she lay there, close to me

and still, far from close.


Our voices echoing

through fragile patient hearts,

as she existed but ceased to exist,

confined to her bed—