The Silence of Brothers

For almost a decade, my elder brother Om lived with a shadow called Myasthenia Gravis.

It is a rare neurological cruelty—a disease in which the body’s own defence system quietly sabotages the communication between nerves and muscles. In its milder form, it merely weighs down the eyelids and makes a person look perpetually sleepy. For years, Om managed it with oral tablets and carried on with life, largely uninterrupted, as if the illness had agreed to stay within limits.

But in 2024, it grew tired of being mild.

Perhaps weary of daily medication, Om stopped taking his tablets. The disease struck back with vengeance. This time it did not settle for drooping eyelids. It went for the throat. It stole his voice. It weakened his swallow. Words became slurred and then scarce. Food became a risk. Even water demanded caution. Slowly, the brother who loved to chat and argue and comment on everything withdrew into a world of semi-solid meals, slow gestures, and long silences.

The Medical Battle

In October 2024, I took him to the Central India Institute of Medical Sciences (CIIMS), Nagpur—an institution founded by our own Dr G M Taori. Dr Neeraj Baheti confirmed what we feared: his antibody levels were dangerously high. His nerves were still shouting instructions, but his muscles were no longer listening.

We tried everything that modern medicine offers in such moments—intravenous immunoglobulin, steroids, and later Rituximab. A nasogastric tube became his lifeline. There were small victories at first. His eyelids lifted. The frightening pool of saliva in his throat settled. But his neck muscles remained defeated. His head drooped forward, unable to hold itself up against gravity, as if even the simple act of looking straight had become too heavy.

For weeks, he shuttled between Yavatmal and Sevagram by taxi, with his wife or his son Raju always by his side. We began living in the rhythm that serious illness imposes: a new drug, a brief stabilization, cautious hope, the journey home, and then the inevitable slide back.

The Erosion of Spirit

The illness eroded more than muscle power. It eroded identity.

Om was a man who valued independence. He had run his own shop for decades. But the world had changed. The relentless tide of online giants, the shifting habits of customers, the new economics of survival—everything had made his old model impossible. He had recently shuttered the shop. The closing of those shutters felt symbolic, as if a part of him had been folded away.

Now he was bound by tubes, dependent on others for the smallest acts of living, and unable to answer the quiet, brutal question that arrives in every long illness: What next?

The Final Decision

On 26 November 2024, Om passed away in Sevagram Hospital.

His oxygen levels had begun to drop. His respiratory muscles, tired of fighting, finally gave way. The night before, I sat by his bedside. He was fully conscious. He pressed his palms together in a pranam, looked up at me, and gestured towards the monitors and IV lines.

Take them off, his eyes said.

Then he motioned for water. He drank slowly, deliberately, as if it was an act of closure. He closed his eyes.

By morning, he was gone.

We had made the hard decision beforehand. No ventilators. No tubes forced into the trachea. No chest compressions. No electric shocks. We chose a dignified farewell over a violent struggle to drag him back into a body that had already decided to let go.

The Burden of Trust

Treating one’s own brother is a burden no doctor should have to carry.

Om relied on me with a faith that was almost terrifying. To him, I was not merely a physician. I was a family member with a medical degree, which in Indian families can sometimes become a form of divinity. He never sought a second opinion. He never doubted a word I said. Over those final months, I spoke to Raju hundreds of times—tracking blood pressure, sugars, swallowing, breathlessness, adjusting doses, watching the numbers change and the man shrink.

Watching him slip away despite everything we tried cut deep. It is a unique kind of helplessness to stand beside someone who trusts you completely, and to know that medicine has reached its limit.

Of the three brothers, Om and I shared a special frequency. It was a bond not only of blood, but of unspoken understanding. We didn’t need many words to communicate. And in the end, when the disease took his voice, it was in that silence that we said our final goodbyes.

Ashok: A Sudden Turn

A year later, another blow arrived—faster, sharper, and without warning.

My elder brother Ashok died on 24 December 2025 in Pune. He was eighty-two. It was a sudden heart attack, the kind that does not give families time to rehearse grief. Ashok had been spending much of that year in Pune with his younger son Sumit and his daughter Surekha, staying with them off and on for three to four months at a stretch. Kanta bhabhi was with him. They had only just decided, two days earlier, to go to Pune again for a month—one of those ordinary decisions that feels routine until it becomes the last.

On the morning of the 24th, he developed symptoms that were unmistakable. I received a phone call from his daughter-in-law, Chanchal. Even over the phone, the story was clear to me within seconds. This was not acidity. This was not “gas.” This was a heart attack.

I asked her to give him two blood thinners and a large dose of a cholesterol-lowering medicine immediately, right there at home, and to take him without delay to Dr Kalidas Bharati, who ran a large hospital in Pimple Saudagar, barely two kilometres away.

I also called Dr Bharati myself. He is an MGIMS alumnus from the 1997 batch, and in moments like these, that Sevagram network becomes more than nostalgia—it becomes a lifeline. He told me he was in the hospital and would take care.

Ashok reached in time. He received emergency treatment, including a clot-buster. For a short while, it seemed the crisis had been arrested. He felt better. We allowed ourselves that dangerous emotion called hope.

Within two hours, a second heart attack struck him down.

We drove to Pune immediately and reached past midnight. The next day, we performed his final rites there, in Pune itself, surrounded by stunned family members still trying to accept the speed of what had happened.

The turn of events was sudden, unexpected, and deeply painful. Yet even in sorrow, we took solace in one truth: his death came swiftly. He did not suffer for long. He did not spend a single day bedridden. He passed away peacefully, without the prolonged indignities that illness so often imposes.

What Remains

In one year, we lost two brothers in two very different ways—one after a long siege, the other in a lightning strike.

Om’s death taught me about endurance, about dignity, and about the slow erosion that chronic illness brings. Ashok’s death reminded me of life’s other cruelty: that it can end abruptly, in the middle of ordinary plans, without giving anyone a chance to prepare.

Both deaths left behind the same silence.

A chapter has closed. The shop is shut. The pain is over.

And yet, in the quiet that follows, one learns to live with what remains: memory, gratitude, and the fragile privilege of having had brothers to begin with.

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