What binds us? Duty, love, memory? And when those bonds begin to fray—what remains?
Uma, the head nurse of a hospice, has spent years tending to those in their final moments. She listens, sketches, writes—searching for meaning in the stories around her while struggling to define her own.
Within the hospice walls, lives intersect in quiet yet profound ways—marked by choices made, truths unspoken, and moments that linger beyond their passing.
And the patients: An old man with a birthday card, kept for years, speaking of a bond severed but not forgotten. Wayne, caring for his wife, Martha, finds himself reaching for a past he cannot repair. Gary lingers in the shadow of his estranged brother, haunted by wounds still hurting. Rob, determined to dictate his own ending, resists surrender until even his willpower fails him. Leila, a mother leaving behind notes for the daughter she won’t see grow up. And Matt, gruff and guarded, finds himself unsettled by his terminally ill son's dog, Jerry.
As Uma observes, she begins to understand—these stories are not just endings, but echoes of what endures. And in witnessing them, she must finally face the truth of her own.
What binds us? Duty, love, memory? And when those bonds begin to fray—what remains?
Uma, the head nurse of a hospice, has spent years tending to those in their final moments. She listens, sketches, writes—searching for meaning in the stories around her while struggling to define her own.
Within the hospice walls, lives intersect in quiet yet profound ways—marked by choices made, truths unspoken, and moments that linger beyond their passing.
And the patients: An old man with a birthday card, kept for years, speaking of a bond severed but not forgotten. Wayne, caring for his wife, Martha, finds himself reaching for a past he cannot repair. Gary lingers in the shadow of his estranged brother, haunted by wounds still hurting. Rob, determined to dictate his own ending, resists surrender until even his willpower fails him. Leila, a mother leaving behind notes for the daughter she won’t see grow up. And Matt, gruff and guarded, finds himself unsettled by his terminally ill son's dog, Jerry.
As Uma observes, she begins to understand—these stories are not just endings, but echoes of what endures. And in witnessing them, she must finally face the truth of her own.
My name is Uma. By day, I tend to the dying. By night, I try to give their stories a shape—sometimes in pictures, sometimes in words. It’s how I make sense of things. Of them. Of myself.
We all do it, don’t we? Take fragments from other people’s lives and piece them together, hoping they’ll reveal something about our own.
Maybe you’ll find something here. A person you recognize. A feeling you understand. A sign that all of this, in the end, adds up to something.
Or maybe not.
Either way, you’re here now. Stay. See where this journey takes you.
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Nobody dreams of becoming a hospice nurse. No kid clutches a teddy bear and says, “I want to hold the hands of the dying when I grow up.” It’s not a thing you aspire to. It’s a thing you end up doing. Or maybe that’s just me.
Yet here I am, fifty-something, in scrubs that still smell faintly of antiseptic no matter how many times I wash them. I count pills into little plastic cups and tell myself—convince myself—that this job was my choice. Was it?
Head of Nursing. That’s a title, isn’t it? It comes with more meetings, more forms, and a weight I didn’t expect. But I still do the rounds. I still sit with patients. Maybe it’s because I don’t know how not to. Maybe because when someone’s face lights up just because I walk into the room, it reminds me—somewhere, deep down—that I matter here. That I belong.
Lately, though, it’s harder. The exhaustion doesn’t lift anymore. It used to come and go, like waves. Now it’s this dull, constant ache in my chest that doesn’t leave. Stress, I tell myself. You’re just tired. It has to be that.
#
I grew up in a small town where everyone knew everyone else’s misery. My mother was a hospital bookkeeper back when cleaning blood off floors was just part of the job. My father? I try not to think about him. If he’s dead, I’ve never had a grave to visit. My stepfather—a dour man with an expression that constantly muttered, I’d rather be anywhere else.
In my teens, I dyed my hair pink, wrote bad poetry, and mistook making people uncomfortable for cleverness. Boys found me intriguing—until I wasn’t worth the effort.
I wanted to study art, to lose myself in paints and charcoal. But my mother’s hospital job taught me one thing: there’s always work in healthcare. Nursing was supposed to be temporary. Just until I figured out what I really wanted. Funny, isn’t it, how temporary things become permanent.
Nursing school was a crash course in how easily bodies break. Blood. Vomit. Organs failing in ways I’d never imagined. But it wasn’t the bodies that got to me—it was the families. The way they begged for one more chance, one more day, one more miracle. The way they looked at you like you could fix something when all you could do was stand there and bear witness.
I saw my first patient die when I was twenty. Mrs. Shah. Liver cancer. A room packed with relatives, their voices crashing against each other like waves until the silence finally swallowed them. Afterward, a senior nurse patted my shoulder and said, “You’ll get used to it.”
I didn’t.
I tried every ward—ER, paediatrics, geriatrics. But oncology broke me. Watching people battle cancer, fight so hard for time, only to lose it anyway. Two brittle years was all I could manage before I landed in hospice care.
If oncology is a battlefield, hospice is the aftermath. No desperate fights, no victories. Just endings. Tethers fraying, unravelling, until they finally let go.
Over the years, I’ve collected stories like fragments of stained glass. I’ve held hands. I’ve whispered reassurances. I’ve watched people shrink into the space between breaths. Patients have looked me in the eye and asked, “Am I dying?” While families cling to hope; doctors avoid the word like saying it will make it real.
But this is the thing; I like my patients. The small rituals they cling to—straightening a blanket’s edge, folding and refolding a tissue, insisting the tea be made just right. They still surprise me, always. The ones who should be bitter but aren’t. The ones who still smile. The ones who find joy even when everything else is pain.
I’m not here to save anyone. My job is to make the inevitable a little less terrible. To be here, to listen when no one else will. And yes, to clean the bedpan—because dignity in dying doesn’t erase the indignities of living.
Why am I telling you this? Because stories tether us to the world. Because, in the end, this isn’t just their story. It’s mine. It’s yours. It’s all of ours.
We’re all heading to the same destination. The least we can do is keep each other company along the way.
By writing When Tethers Fray, Rajiv Mittal has not crafted a traditional novel. Like all true masters of literary fiction, Rajiv has withdrawn from traditional storytelling, prioritizing plot, to take a deep dive into an exploration of the human condition. Crafting a richly layered collection of stories about the choices we make and the burdens we carry, Rajiv’s When Tethers Fray examines the roles we assign ourselves and the origins of our beliefs and habits. As his characters wrestle with death, they expose their fractured relationships. They question the choices they made. They confront the image they have created of themselves. And they force us to confront our own.
Rajiv’s protagonist, Uma, is the head of nursing in a hospice. At work, she strives to provide comfort to the dying. At home, she sketches and tries to make sense of her world. “We all do it, don’t we?” she says, “take fragments from other people’s lives and piece them together, hoping they’ll reveal something about our own.” Uma is not a character you fall in love with and cheer for. Rather, she is one who disturbs you, and steals your comfort. As Uma strives to make sense of her life and her world, she challenges us to strive to make sense of our own.
Rajiv Mittal is both a philosopher and a wordsmith. He paints vivid pictures with his words, but he also tears at the heartstrings and demands reflection. He pushes at the boundaries of our reality, forcing us to question our core values and our deepest beliefs about life, relationships, and the ultimate ending that we must all eventually face. He challenges our understanding of our own identity and that of those who surround us.
When Tethers Fray is not a book you read for momentary pleasure. You cannot devour it quickly. Parts of it are hard to read. Parts will tire you, and yet you want to linger over the wisdom in the words. Rajiv Mittal’s words demand deep contemplation. The various stories he tells challenge you. Some may shock you. Some may leave you protesting loudly that life should not be this way--that people should not be this way. And yet you know they are. You know that children abandon parents and parents fail children and husbands betray wives and wives test husbands. You know that love does not conquer all, and that, ultimately, death prevails over strength and control, even for the strongest and the most determined. You may understand duty, or you may deny it. Like Uma, you may see duty as a burden. Yet you know that, for some, duty is all there is. Whatever wisdom you take from Rajiv’s words… whatever questions it leaves you asking and whatever insights you find in these tales of dying, one thing is certain: This is a novel that will leave its mark. Read it, and you will never think or feel the same again. Surely that qualifies it to hold a place among the works of the great masters? If you appreciate the finest works of literary fiction, this is a book you should read. It’s one I will keep to read again, for a single reading cannot do justice to a work of such depth and purpose.