Two unbelievable deaths: lessons in grief

“I am sorry you have to go through this again.”

My son Gareth’s internist ended the phone call with these devastating words. I could not believe what I was hearing, on my cellphone, a continent away from the intensive care unit (ICU) in South Africa where our youngest son was battling for his life with COVID-19 pneumonia.

At the end of 2020, I had retired from 40 years of medical practice in Canada. My wife and I chose to retire to Portugal to be closer to our growing family. We had become a global family: Gareth was recently married in South Africa, and Matt, our older married son, was living and working in the United Kingdom. Matt was the proud father of a two-year-old boy, with another baby on the way in six months’ time. Both of our sons were 31 years old, having been born 11 months apart.

We were in South Africa in January 2021, after attending Gareth’s wedding, when we received a phone call from Matt in the UK to say he was unwell with a fever and chest pain, but the home COVID-19 antigen test was negative, and he told us not to worry. I recommended he go to the local hospital emergency department; there, the polymerase chain reaction test was positive. He was immediately admitted to intensive observation because of his chronic pulmonary condition. He told us he was feeling OK, but I felt an immense sense of dread, since I had cared for patients with COVID-19 during my hospital practice. Matt was on his cellphone constantly, FaceTiming us from the time of admission to the time of his intubation a week later.

And so started our descent into COVID-19 hell. Through it all, I tried to reassure my family that Matt would get through this ordeal. I phoned the ICU nurses every day to get an update on his clinical status. Rarely, I managed to get hold of a doctor, but each was equally guarded in their assessments. All I wanted was an honest answer, as I had to prepare my family for the worst. I felt helpless as a physician and a parent. As physicians, we are trained to care for patients, have a treatment plan and have a positive attitude. I felt abandoned by medicine, my profession for 40 years.

We witnessed in real time Matt’s progressive deterioration, thanks to video call technology. He FaceTimed us suddenly at lunchtime while we were sitting with my wife’s family. I will always remember this; it was a beautiful summer day in rural South Africa. Matt was gasping for air, saying he couldn’t breathe! His physician wanted to intubate him that afternoon. He said goodbye with tears rolling down his face. He understood what he was up against. He asked us to look after his young son and unborn child.

He died two weeks later from multi-organ failure, without ever regaining consciousness.

The following week a letter addressed to him arrived at his home from the National Health Service with an appointment for his first mRNA vaccine.

We attended Matt’s funeral in the UK by video link two weeks later. We then left South Africa and returned to Portugal, to grieve the loss of our beloved son, a kind and generous young man with a big heart.

Six months later, my sense of dread and anxiety returned when Gareth and his new wife contracted SARS-CoV-2 and I once again assumed my role as family messenger, interpreter of results and prognosticator. The vaccine rollout for their age group had not yet started in South Africa. Gareth was admitted to hospital shortly after diagnosis and spent the next two weeks progressing from the COVID-19 ward to ICU and finally to intubation. His respiratory physician kept us in the loop via WhatsApp.

Gareth was constantly on FaceTime saying, “I can’t breathe,” “I don’t want to die,” “I don’t want to be like Matt, please help me.” I would try to talk him down from his anxiety. I told him he would get through this ordeal. What else could I do? Was I lying?

South Africa was under strict lockdown at the time, and we could not travel there to see him. Instead, we travelled that week to the UK to see our grandchildren. We received the news early one Saturday morning from our daughter-in-law that Gareth had died early that morning from a tracheostomy complication.

I have a terrible feeling of helplessness and guilt as a parent and a physician, that I could not be there at his bedside. Such absolute loss and sadness will haunt me for the rest of my life.

We eventually managed to travel to South Africa for Gareth’s funeral.

Within a brief six-month period, our sons — the lights in our lives — were gone. Grief counsellors call such profound devastation and loss “compound grief.” I now understand how it must feel for parents in a war, where a missile destroys your home and kills your entire family. How do we now find purpose and meaning in our lives?

Reflecting on our tragic journey in 2021, while flying between continents and navigating lockdowns, I am still at a loss to understand why some people, including a few of my own family members, who went through this tragic ordeal with us, remain adamant anti-vaxxers. Nothing I’ve said to those family members, including sending them the latest published, evidence-based findings, has shifted their vaccine-hesitant view. So many people around the world rejected mRNA vaccines as dangerous. On a visit to Edmonton in November 2021, I witnessed a violent anti-vaccine protest at the university hospital. It was devastating to see people rejecting the vaccine that might have saved my sons’ lives.

My wife and I try to move forward day by day. We keep the memory of our sons alive, in our growing grandchildren.