A Grandmother’s Gentle Goodbye and the Child Who Carries Her Name – By Ruben Vighnesvaran Some moments stay with you forever. One bright Tuesday morning, as I opened my office door to call the next patient, I found an elderly man gently applying ointment to his wife’s feet while she softly protested the fuss he was making.
I knew I was about to meet a couple whose love had endured more than time—it had endured hardship, sacrifice, and now, illness.
“Rani?” I called. She looked up, and I gave a small nod, inviting her in. Rani had lived a hard life. She and her husband were rubber tappers and struggled to raise three children. A woman of few words, she never completed primary school, yet she carried a deep wisdom about life.
She moved slowly, leaning heavily on her husband’s arm. The toll of her illness was evident in her frail frame, but her dark, steady eyes met mine with firm determination. She settled into the chair, weighed down by exhaustion.
When I asked about her symptoms, she described the pain that followed her every movement, making even the simplest tasks difficult. She knew her ovarian cancer was advanced, yet she held onto hope that we could ease her suffering.
“Come, let’s get you comfortable,” I said, offering my arm as she shifted onto the couch. Her body tensed as she adjusted, the silent grip of pain evident. I gentlypalpated her fluid-filled abdomen and pressed on her swollen legs. When I offered to drain the fluid through paracentesis, she agreed.
Her husband hovered nearby; his face lined with concern. “The doctor said there’s nothing more to be done,” he murmured, his voice almost apologetic, as if afraid to hope.
I hear this statement often in my practice, and I can’t help but wonder how crushing those words must feel—like a door has been permanently shut, leaving no way forward.
Access to basic palliative care is limited, and specialist services are even scarcer. Even where they are available, referrals tend to come late, when patients are already in the advanced stages of their illness.
As the nurse secured the cannula and opened the tap to drain the ascitic fluid, I sat beside Rani, holding her hands. “Tell me, what’s most important to you right now?”
She exhaled slowly. “My daughter is expecting. She is due in a couple of weeks. I want to meet my first grandchild.” Simple words, yet they carried a weight beyond measure.
I nodded. “Let’s focus on that.”
Over the next few days, we controlled her pain, adjusting medications to keep her comfortable. We arranged for the community palliative care team to visit her at home, ensuring she had support when she could no longer come to the clinic.
Our visits became less about her disease and more about her—her fears, her hopes, and the love she held for her growing family. A month later, she returned, her steps slower, her breath more laboured. Clutching her mobile phone, she was eager to show me photos of the newborn.
“She’s here,” she said, her voice a mix of exhaustion and triumph. “My granddaughter.”
Her fingers trembled slightly as she handed me the phone. The baby, snug in a pink blanket, lay asleep in her mother’s arms.
“They’ve named her Rani,” she continued, a flicker of mischief in her tired eyes. “The next queen in the family.” In Tamil, Rani means “queen.”
I smiled. “A fitting name.” We spoke for a while about how she was coping and whether there was anything more we could do for her.
“God answered my prayers—I have seen my grandchild. What more could I ask for?” she said, a gentle smile lighting up her face.
Even in the face of illness, the arrival of a new life symbolizes hope. Seeing the next generation reinforces the natural rhythm of life. Meeting her granddaughter was more than a fulfilled wish; it was a profound spiritual affirmation that her life had come full circle. She had given, she had loved, and now she could leave in peace, knowing she had left behind something beautiful.
As she rose to leave, she reached for my hand. “Thank you,” she whispered. And I knew—this was goodbye.Two weeks later, the call came. Rani had passed away at home, surrounded by her family. Two days before she became unconscious, she had held her granddaughter and whispered blessings in her ear.
She left this world with the same quiet determination with which she had lived.
Palliative care is not just about easing pain. Symptom relief is not the goal itself but a means to a greater end—ensuring quality of life and honouring what matters most.
For Rani, it was the chance to meet the next ‘queen’ in her family. And in those final days, despite the challenges from her illness, she found joy, purpose, and peace.
Rani’s journey stayed with me long after she was gone. Her story reinforced a truth I have come to believe deeply: even in the face of illness, life continues to hold meaning. Hope does not disappear; it simply transforms.
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About myself
Dr. Ruben Vighnesvaran, has spent over 20 years serving in public hospitals across Malaysia. Now working in a palliative care unit, he continues to learn about the true essence of life from the patients he cares for—his greatest teachers.
Guided by the words of Dame Cicely Saunders—‘You matter because you are you, and you will matter till the very end of your life’—he strives to provide care that upholds dignity and meaning, even in life’s final moments.
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