How I Kept My Grandfather's Trust by Lying to Him...
Pancreatic cancer. Stage 4.
Five-year survival rate: 1%.
We were certain that he would break all odds and be a part of that 1%. After all, the studies that provide us with these data don’t consider having spent the first 65 years of your life outside of the US.
They don’t consider your current diet, health practices, or family support.
“He’s too healthy and independent to be brought down by cancer,” I thought.
I spent a year at the hospital with my grandfather as he fought cancer. I had always attended all of his medical appointments and translated for him, but I ran out of words when I needed to tell him he had been diagnosed with stage 4 pancreatic cancer. I knew his next question before he asked it.
“Is it curable?”
I had no answer.
There is a general consensus that I shouldn’t have been answering anyway. Family dynamics often bias the information being given to the patient. But I don’t think my grandfather would have received the quality of care he did if I wasn’t there to interpret for him.
Nobody knew my grandfather’s health condition better than I did. I knew his medications, past medical illnesses, allergies, symptoms, his worries and concerns. He lived with my family. I was well aware of his health at all times. He wasn’t someone I saw a few times a year. I grew up with him.
He was a father-figure to me.
I first started translating when we had just come to America. I was only nine years old.
My medical translation skills improved as I became more fluent in English, and have continued to evolve with my involvement in the healthcare field. This evolution helped me to understand why physicians wanted to talk to my grandfather through the hospital assigned translator and not through me. I knew they have to follow hospital protocols and could get in trouble if they didn’t.
However, I became anxious when I had to sit on the side and listen to someone else interpret for him. It got worse when I heard them interpreting incorrectly!
Throughout the year, I had some physicians who trusted my medical interpretation skills, aware of my background in healthcare. There were others, however, that refused to let me translate. Often. The doctors treating my grandfather did not know that he needed a translator until they had walked into the room. At that point, it was too late to call an interpreter to come in physically, so they would call someone over the phone or through video-conference. It was fine when I could at least give him a warning about what was going to happen and what they will be talking to him about, but there were times when I wasn’t allowed to give him this warning, and I’d be forced to stand by helplessly as he searched for some understanding, confused about who was talking to him in Punjabi all of a sudden.
Unfortunately, he wasn’t the only one that felt confused.
The interpreters often had no information on his diagnosis, his current health status, the current situation he was in...
I remember my grandfather being so confused about the questions that were being asked that his physicians began to worry that he had no idea what was going on with this health. I could also see a glimmer of suspicion that I -- his own granddaughter! -- had been lying to him about his health to save him from the truth.
The truth is, sometimes I had to lie. But not to keep him from the truth. Instead, I lied because I had to keep his trust.
I was told he had stage 4 pancreatic cancer. It wasn’t stage 4.
I was told that his bile drain was permanent. It came out two days later.
I was told that his cancer had metastasized to his liver. It turned out to be old marks from an infection.
I was told he had a 3rd degree AV block. Somehow his EKG was normal two weeks later.
I was told he would only make it for a 2-3 months. He fought for nine months.
If I told him everything they told him, only to find out that it wasn’t actually true, he would have lost faith in his physician. He may have even lost faith in me.
I had to keep his faith in both.
I wanted to protect him from the uncertainties of medicine. Hence, I would wait until I had a final confirmation, after multiple tests, to deliver an update. If I told him his cancer went to his liver, only to later retract that statement and say, “actually, it’s just marks from an infection,” I knew I’d put any trust or faith he had in jeopardy. I couldn’t do that. And he wasn’t the only person I had to lie to.
I lied to his daughter, my mom, and his son many times about his health update until I could come up with a way to tell them the news. I would tell them that I hadn’t talked to the doctor yet so I’d have more time to prepare my words. I remember trying to translate what DNR was to them.
Do. Not. Resuscitate.
“Do you want them to try to save grandpa if something happens to him?” I asked.
“Of course!” they replied. Of course that was their reply. Why wouldn’t it be?
Well, if they knew that the measures taken to save him may actually kill him or lead him into a worse health situation…
It became much harder when I had to discuss the DNR form with my grandfather.
I translated with tears in my eyes.
“So, is this the end?” he asked.
How much did he trust me? I was his medical power of attorney. He turned to me for every medical decision that had to be made. He found comfort in the care I provided him, mentally and physically. I slept at the hospital every night to ensure he would not feel abandoned. Maybe I was wrong to lie to him. I was just trying to protect him.
Two days before he passed away, I left Seattle to come to PNWU.
“You’re going to be just fine grandpa,” I said. “I will be back in just a few days to see you. Wait for me.”
I knew he wasn’t going to be fine.
I just wanted him to believe in hope more than science.
Osteopathic Medical Student - 2nd Year (OMS II)
College of Osteopathic Medicine
Pacific Northwest University of Health Sciences