The Tea & Toast Diet

I looked down at my phone around 2pm on a Monday afternoon as my 11 month old son blissfully played in front of me. I pressed call again for the 3rd time that day. No answer.

I frowned.

Trying not to imagine the worst, I texted my sister.

"Did you talk to grandma today?"

"No, this morning was such a rush, let me call now- She's not answering."

I texted our aunt.

"Aunty, did you talk to grandma today?"

"No, I spoke to her last on Saturday evening she was fine."

My heart began to beat a little faster. I called her neighbor, no answer. He called me back but he hasn't spoken to her either, he tried knocking at gate earlier in the morning but assumed she was out. He reassured me that he would go back and check.

I called him back, he let me know that she was not doing well. She was on the ground, wet from relieving herself on the floor and confused.

My heart stopped. My worst fear, coming to pass? The one thing I think about if she doesn't answer the phone is happening?

Every time I call, she's in a great mood, I hadn't spoken to her much that week but my sister told me she wasn't well and she saw a doctor who treated her and she feels better. I took it for granted. My grandma, 83 years old. Self sufficient. Independent. Feisty. Friendly to all. Strong.

I ran through all the possible scenarios but my brain was replaced with concrete. Hands shaking, I asked the neighbor to put her on the phone. She spoke nonsense. The familiar sound of delirium. I called an ambulance and they get there in 10 minutes.

The next two days, my body in one country but my heart in another, I spent the nights weeping on my husband's shoulder. I spent my flight to her thinking of the last 32 years of the one person who has been a constant in my life. Who saved me when I was a newborn when my parents couldn't keep me. Who fought for me when they felt I was unsafe. Who gave me everything and took the worst parts of my teenage rebellion with an entire generation between us, drove me to school, picked me up, packed lunches, dropped me to dates.

Watched my drive away when my Dad decided it was time for me to live with him when he was diagnosed with cancer.

Came back and picked my sister and I up whenever he was frustrated enough to kick us out.

Who supported my medical dreams. Who came to all the PTA meetings. Who came to all the graduations.

Who hid her medical problems from me just enough so that I swooped in and saved her when she bled so much her hemoglobin dropped to 4. Who's insides I saw when I peeked through the operating room door as they excised the bleeding part of her.

I remember having to sign that consent form five years ago. "The next bleed could be her last" my colleague said. I signed the form knowing fully well she would never be the same again but she would be alive.

She stayed alive. She supported me through my divorce. Celebrated my second marriage.

Who couldn't eat and wept as I suffered through 36 hours of labor. Who lights 3 deyas for every exam I have ever taken and job interview.

The CT scan shows a brain-stem infarct. A stroke. A stroke? My grandma had no risk factors and a clean bill of health. I always make sure.

A clean bill of health.

I flew home to her. Heart swollen as I sentimentally gaze upon my home country from the sky as we prepare for landing. The next day, her MRI was clear with no evidence of a stroke. The doctors couldn't find a reason for the fall.

I saw the woman who I always held in my mind as well put together, nails, hair make up and well dressed. Now looking, frail, old, weak. Being carried like a baby by my brother in law. The house, not cleaned in months. Old food in the fridge. Dust. The kitchen floorboards falling apart under deceiving new vinyl. My heart shattered.

How could I have been living so comfortably while someone so close to me lived in this way and I had no idea?

It never dawned on me before that she would be the classic vignette I had answered questions about. Patients I have treated. But it couldn't be, she was my grandma. She never let on to any problems, hid how she felt, that she couldn't manage to cook or live on her own anymore. I asked her what had been happening but she said that she didn't want us to worry. She was okay. She’s been having tea and crackers, toast too. It’s easier on her teeth. Oh and she saw a doctor. He said she would be okay and gave her a B12 shot and tablets to sleep. Tablets for the dizziness. Tablets for the burning in her feet. Tablets for the headaches. Tablets. Tablets. Tablets.

The patient on the tea and toast diet also experiencing poly-pharmacy, which contained benzodiazipienes. Valium.

She took half, half wouldn't do anything she thought. Plus she didn't sleep the night before and could do with the rest. She woke up dizzy and fell.

I cleaned the home I grew up in, threw out bags and bags of old items and expired food. combed her hair, painted her nails. Encouraged her to walk, cooked her eggs, paid bills, did groceries. Cleaned her wounds from where she injured herself. Had the floors replaced.

She didn't need pills, or shots or a long hospital stay. She needed love, attention, care and agency. Fresh fruit and vegetables, a clean living space, her family and friends reminding her how loved she is. Isn't that all that anyone needs?

The more I thought about it, I realized, that we sometimes take it for granted that the people we are closest to, and they will not reveal things that they think will break our hearts. They try to fix it on their own, even as they stand outside the realms of their capability. But we owe it to them to ask. In those times where I assumed she was okay, I should have asked her. How she was feeling, what did the doctor say? Does she need someone to come in and clean this week?

I spent a week, keeping her as my sole focus. Something I had not done in a while, having been preoccupied with a baby. No excuse. I made a promise to her and my grandfather, that I wouldn't let anything happen to her. In my chest, I felt a weight. Like I had let them both down. I choked back tears each time I looked at her. But when I left, I left knowing that I did the absolute best of my means and ability to ensure she knew how much she meant to me, to all of us. And that measures were put in place to ensure she would never have to feel the opposite again.

She would have care, family, help. Something we should have put into place a long time ago. I promised to go visit her as much as possible, we talk twice a day. Most days. Care-giving has gone from 24 hours to just 3 times a week. She's thriving again. But of course she would, because that's who she is.

She looks like the grandma I know and have always known and loved, and I won't ever take that for granted again. We owe it to the ones we love to check in on them, especially the ones who are used to taking care of us.

The week after I left, was the festival of Divali. Even though I couldn't be there, for the first time in 20 years her small family gathered around her, her great grandchildren ran and played, my sister's laughter echoed. The house had light, life and laughter. And so did she.