In July of 2013, at the end of my intern year as a medical resident in Brooklyn, New York, my younger brother and only sibling Ashish was diagnosed with stage 4 soft-tissue sarcoma. He was only 27 and had just been accepted to medical school to follow his dream of becoming a psychiatrist. At the time he was diagnosed, he was having shortness of breath that couldn’t be explained and his chest x-ray showed that he had hundreds of nodules in his lungs. Though doctors who heard his case proposed alternatives to what was most likely metastatic disease, the inevitable reality finally hit our family. It was cancer and it had already spread to not only his lungs but also his brain. We were told that he had less than a year to live at best, leaving little in the way of curative therapy.

Within about a month, he was bed-bound and oxygen-dependent. We searched medical literature for answers and enrolled him in an experimental chemotherapy trial through the National Institutes of Health(NIH) in hopes that we could buy more time. But as time passed and his functional status steadily declined, Ashish finally succumbed to his illness and died in his bed at our home in Texas in March 2014. My parents and I surrounded him as he took his last breath and it comforted us to know that his final moments were pain-free.

Losing my brother was the most painful thing I hope I will ever have to experience.

It turns out that nobody is ever prepared for grief. It doesn’t arrive predictably in time or severity. It can be an overwhelming, moaning, sobbing kind of grief. Or it can ache just enough to remind you it’s there and yet somehow you never want it to go away. Looking back on my experience with loss and tragedy, I wonder how I came back to work and managed to get through the days of sadness and overwhelming feelings of loss. But then I realized that it wasn’t a miracle that I made it through. It was because of the constant support and camaraderie from my colleagues, my friends, my family and my wife that I was able to continue to perform and get through the days. I was never alone in my grief. I recognized that the more I shared my vulnerability with others, the more they mobilized to lift me back up when I couldn’t stand alone.

While my brother was sick, I went home to see him as much as I could. I remember very distinctly the last time that I visited him before he died. He had been told by his oncologist days prior to my arrival that there were no treatments left and that hospice care was the best option for him. As I spent time with my brother — this person who was so debilitated and vulnerable and only a semblance of the person I knew him to be physically — I was so struck by how little our conversations and his spirit had changed. Through the chemotherapy, weight loss, radiation, and quick decline in daily function, the essence of who he was never left our interactions. When he died, the close relationship I maintained with my brother during his illness helped me realize that his departure from our lives and from humanity had no relation to the methodical sequence of events that followed: the zipping of his body into a bag, the funeral, the cremation. His vitality was much bigger than that.

And so I promised myself that I would never forget his vitality, his spirit, his enthusiasm for life and his love of learning. I got through very tough times and continue to cope with his loss by always remembering that though his illness debilitated his physical body, the essence of his spirit never changed. Shortly after he died, with the help of friends and family and those who were touched by his life, we established the Ashish Patil Memorial Prize through his alma mater, Vassar College. Ashish embodied what it meant to be a well-rounded and dedicated student who was devoted to fostering his intellectual growth. This year, we were so happy to see the first student awarded the prize.

Over a year after his death, I’m still learning how to live and be happy without my brother. I am proud to share that I just graduated from my residency training program and will begin my career as a physician! I also recently married my wife, Stephanie, and am excited about our future together. Though Ashish was not there for the wedding and will not physically be there for our upcoming milestones, he is always close to our hearts and will be forever missed.