(by Parul Dua Makkar, BSc, DDS, FACD)

When I lost my younger and only sibling, Dr. Manu Dua, my world shifted in an instant.

I didn’t have the comfort of a village of grief to wrap around me — no circle of people to act as a buffer from the pain. My parents were in another country, holding on to each other as they endured the same heartbreak. And yet, losing a sibling is a very particular kind of loss — it strips you of your identity, it severs part of your past, and it steals the shared future you once took for granted. A sibling is a friend for life, someone who bears witness to a life you once had, who helps create new memories. The one who knows your family’s little nuances, inside stories and a part of your identity.

It was March 2021 — the worst possible loss in the worst possible time. COVID still hung over the world like a shadow, isolating us from one another when we needed connection most. Like many of you, I wear many hats: mother, dentist, practice owner, wife, daughter, daughter-in-law, sister. In those early days, I wished the world would stop so I could step off and begin to make sense of what had happened.

The day before Manu died, my parents told me he was being moved to hospice and that they were meeting with the palliative team. I was in the middle of a fully booked day of patients. I didn’t know more, and I couldn’t simply walk out. I had to push aside the thoughts of my brother’s worsening condition and focus on patient care, as though my world wasn’t about to shatter.

The next day, I spoke to Manu on a video call. I told him not to wait for me, to let go, to stop hurting — as I watched him struggle for each breath, the morphine dulling but not erasing his pain. I told him, his fight was over, but his journey wasn’t. Meanwhile, I was scrambling to get PCR testing to cross the border from the U.S. into Canada with special government clearance. I was a day too late.

I spent the next two weeks in Canada helping my parents plan his funeral, followed by a week in quarantine — part of the rules back then. And then, I returned to my young family, my patients, my fragile new practice, and the looming financial pressures.

Without a village to cushion me, the grief landed hard. Anxiety became my constant companion. Sleep became a stranger. Grief came in waves — sometimes crashing over me like a tsunami, other times arriving in the form of quiet tears or bittersweet memories that made me smile through the ache.

And then, in December 2024, I got a call from my mom, “Your father had a sudden cardiac arrest, he’s in the ICU on a ventilator.” It was deja-vu again. Frantic emergency flight alone, I was prepared by the ICU team that my dad would not survive. I was mentally prepared to plan another funeral, write another eulogy. I had to get my office ready to inform patients, reschedule, as I made sense of my current reality. My body knew this familiar trauma.

When I saw him on the ventilator as soon as I landed, I knew what had to be done. That man who lay there was not my father, he was long gone. There lay a shell of a brilliant man I once knew.

Losing a parent after losing a sibling is a different kind of pain — it doesn’t replace the first grief, it layers on top of it. It reopens wounds you thought had closed. My father’s passing reminded me that grief is not a single chapter, but a continuing story. Every loss changes the way you carry the next one. It is not only the absence of the person you miss, but the absence of their voice, their wisdom, their presence in life’s ordinary moments.

From these losses, I learned to be deeply grateful for those who remain after the flowers have withered and the phone calls stop — the ones who remember birthdays and anniversaries, who check in on days that matter, who sit with you in your loneliness.

I learned to set boundaries, to say “no” when I didn’t have the energy to show up as my best self. I learned to speak my grief aloud, to let it breathe, and in doing so, I began to build a new kind of village — one formed through shared stories and understanding.

I also learned something about faith. I lost my belief in God as I had known it, but I discovered a different kind of divinity in the universe itself — in the idea that energy is never destroyed, only transformed. When someone crosses over, they are not gone simply because our senses cannot detect them. There are signs, if we are willing to see them.

One of the most profound signs came in April 2022, when my husband and I took the trip to Maui that Manu and I had originally planned for April 2020. COVID had canceled it the first time, and then Manu’s cancer had returned, leading to more surgeries, chemo, and radiation. After his passing and the lifting of restrictions, my husband and I followed the same itinerary Manu and I had mapped out.

We drove the winding road to Hana, eventually wandering into the town itself — a place of just a thousand people in the middle of the Pacific. As we passed through its narrow streets, I saw something that made me ask my husband to turn back. There, in front of a house, was a sign that read: Hale Manu — “House of Manu” in Hawaiian.

I whispered to the universe: That’s where you are, Manu. You’re okay.
At that moment, I knew he was near me, always. Since then, there have been many more signs — small reminders from both Manu and my father that they are still part of my journey.

My hope in sharing this is that for anyone living a life that has veered from the one they planned, anyone holding cards they never asked to be dealt, you remember: people come into our lives for a reason or a season. If you keep doing good, if you keep showing up with integrity, the universe will guide you in mysterious and wondrous ways.

Grief has no timeline and follows no set process. It is individual, shaped by our relationship to what or whom we’ve lost, our life experiences, and the support we have around us. Some may cry openly, while others grow quiet and inward; some find strength in busyness, while others need stillness to process. There are many forms of grief—anticipatory, complicated, collective—and each carries its own weight. It doesn’t show up the same for everyone, and that’s okay. Giving yourself the grace to acknowledge that this is hard, and allowing yourself to seek help, is not a sign of weakness but of wisdom. Healing may not mean “moving on” but learning to carry the loss differently, in a way that honors both your loved one, your pain and your resilience.

As healthcare providers, we often put our patients first — even when we are grieving inside. It takes 9 months to create life, and it is celebrated and you are given that time to prepare. With death, sometimes it comes with no warning, with no time to prepare for the change in the balance of the family’s ecosystem. We are expected to carry on as if nothing has changed. However so much has and so much of you changes. I want you to know: you are not alone in your grief and this journey doesn’t need to be traveled alone. I have walked this path, I understand its unique challenges, especially as a healthcare provider, where we put our needs below others. I will walk beside you if you need someone there.

I see you. I hear you. You have a sister in grief.

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If I can help support you, reach out: https://www.duagoodjob.com/schedulecall