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Tuesday, September 22, 2009

On Death

How do you tell a wife that her husband has died. I truly do not know. You cannot 'break it' easily. In that millisecond between when you believe your spouse is still alive and suddenly learn that they are not, reality is suspended and rationality ceases. It is too much for the soul to accept.
I was 'on call' for the first time in 15 months today and was covering for my partner who is out of town. I saw his patient this morning who had a procedure on Friday to control bleeding from his prostate. He was fine and we discussed possibly sending him home tomorrow. At noon I got a call that he was 'coding' meaning that his heart had ceased to beat and he was receiving CPR. I arrived to find the code team fighting frantically to save him. They worked heroically, each nurse taking his or her turn giving chest compressions while the hospital physician was directing the effort. He didn't make it.
I knew that his wife and daughter were on their way and found them in the hallway. My search for a private room to speak with them came up empty as they sensed the seriousness of the situation; I could no longer delay. Their emotions mounted as I explained the events as they unfolded, ultimately, however, you cannot avoid that moment when you flatly state, "He didn't make it" or "He is dead." Euphemisms don't soften the reality. If there were a better way to say it; I wish I knew. I felt horrible. They could not handle the immense gravity of receiving the worst combination of words that can be strung together in any language. I stood there silent, feeling completely impotent in any attempt I made to try and comfort them. I did not know what to do. Finally the nurse came and had found a private room where I could take them where their uncontrolled grief could be expressed.
In every crisis there is often someone that those suffering can turn to who remains their link with reality. Soon her son arrived and he became that rock for her. I was grateful for his strength in that moment. It was as if he became my translator for the rest of the family.
As I drove home today, I wondered if I could have handled the situation better. Probably, but I still don't know how. I remember a similar situation when I was the trauma surgeon in the ER at UC Davis many years ago. A 16 year old boy was brought in with a fractured spine from an automobile accident on Interstate 5. He was the only survivor. His mother, two brothers and grandfather were killed instantly when his grandfather fell asleep and drove into the back of a semi-truck parked on the side of the freeway. It was my task to call the father in L.A. to tell him about his surviving son. He then asked about the others. My first response was to say that they were seriously injured. The nurses in the room with me were saying under their breath, "You can't tell him they are dead over the phone." But eventually he asked, "Fatally injured?" I could not lie. I only said, "Yes." I heard only sobbing for what seemed an eternity. Finally, I got the number of his father and pleaded with him to stay home until I could contact his dad to get to his house. I couldn't imagine him alone with this burden that I had laid before him.
It doesn't get any easier 20 years later.
I was once in a seminar on death and dying where they asked "How do you want to die?" Which was followed by an academic discussion on he subject. But today I learned that that is the wrong question. If someone were to ask, "How do you want your spouse to die?" I guarantee that the dialogue would not only not be academic, it would not exist. Who can fathom such a question? Yet, it is the survivors who must live through that unanswerable query. It is not a question of age or being at the end of a fulfilled life, death is death. Ultimately, our faith will give us strength. But that moment of finality can be terrifying for many. Is it better to go quickly and unexpectedly or be prepared with a slow and painful demise. I thought I knew the answer to that. But previously I only saw it from the perspective of the one dying, not the one letting go. I saw it differently today.

Kevin

8 comments:

Brooke Trogdon said...

Um wow, I'm not sure what to even say. I don't think I could do that, even though I've been told my family members have died. Never in person though, always on the phone. I'm not sure that is supposed to be easy to say those things, if it were, then we've become too calloused. I hope you have a better day.

Love,
your niece Brooke

Aunt Renie said...

Dear Kevin, thank you for your thoughtful exploration of this important issue. Having been on the receiving side of an M.D. who was very uncomfortable giving me the bad news, I can say it is helpful to have thought it thru. I am sure you were as compassionate as possible and as such, wish you could do ANYTHING to help. When there's really nothing anyone can do except be there. Platitudes, any comments at all, just interfere with the survivor processing this profound loss.
You ask which is the best way to go We saw Anita go unexpectedly in a crash, and saw Art linger waste away with cancer, but had time to say I love you & good-bye. What I learned from this is that your everyday relationship is what counts in a loss. To the degree you express love & are at peace with one another, you will have that peace to carry forward. I also believe the death of a spouse is the most life-changing. The death of a child impacts your future. Of a parent, your past. Losing your spouse impacts your present. But it's still a present.
love, Aunt Renie

Anonymous said...

That is so sad! I am constantly reminded how fragile life is. I don't think you are ever prepared to let a loved one go. Although we have the compfort that we can see them again, it is still very difficult.
Rachelle

Darlene Anderson said...

Again, you expressed your thoughts in a way that transports your feelings. For me, having someone I love pass away changes everything and it's a terrible mixture of pain and beauty. Processing the pain simply takes time, not to eliminate but to learn "where to put it" in my life. The beauty rises to comfort, enlighten and inspire. I'm also learning the importance of sharing my love and gratitude with others.
I know this, I love you and am happy to be in the same family; I'm glad you're spending your time loving and enlightening others.

Aunt Renie said...

On Saturday, we attended the BMT Annual Banquet for patients, their caregivers and medical staff. A grateful patient introduced each of the 5 or 6 doctors of different specialties, with humor and gratefulness. Each doctor spoke briefly with grace and also gratefulness. I loved the patient given 18 months to live who is now celebrating 6 years & doing well. Her doctor said she was a inspiration & her cancer should not have such a Disney-like name. Then he sang
'SUPERCALIFAGILISTICAMALOI-OI-DOSIS!
It was inspiring to be part of this group, tho the MDs asked for a moment of silence for those who were not there. We are all touched by the indomitable human spirit, unflagging efforts and modern medical miracles.

Anonymous said...

Greetings, I read your blog from Sept. 22nd to Rich. His immediate response was the patient probably had a pulmonary embolus related to his cancer. We really enjoy reading your website. You are wise, gentle, sweet soul. And a gifted writer. You should write a book. Happy you are feeling better.

Elle from Anchorage

Anonymous said...

Greetings, I read your blog from Sept. 22nd to Rich. His immediate response was the patient probably had a pulmonary embolus related to his cancer. We really enjoy reading your website. You are wise, gentle, sweet soul. And a gifted writer. You should write a book. Happy you are feeling better.

Elle from Anchorage

Aunt Renie said...

Dear Kevin, please put a new, more up-lifting title on your blog. Hope you are doing well.
love, Aunt Renie