For as long as I remember I have enjoyed reading obituaries. Reading about the lives of those who once shared this world makes me more aware of my humanity as well as of my mortality. With the exception of famous people of whom I know some things, most of the obituaries I read are of complete strangers. About grandpa who fought valiantly in World War II; or grandma who always gave of herself and is preceded in death by her loving husband, 6 sisters, 4 brothers, 2 daughters, 1 grandson; or baby Jesse who only lived 10 days and leaves behind 2 older sisters, Mom and Dad.
I especially enjoy reading the obituaries in my college alumnae magazine which recalls remarkable accomplishments and quirky personalities of those that came before me. Unfortunately, obituaries in local newspapers are rarely that detailed and colourful. However, now that I live in a small town, I have come across the obituaries of patients that I have taken care of at one point or another. Patients I knew were dying. Patients I sent home on hospice. Patients that I set up follow-up visits for fully expecting them to walk through my door in 2-3 months.
Truth is, as a busy physician, I rarely think about my patients beyond their encounters with me. Think about them in the role of someone’s wife, someone’s mother, someone’s child, or someone’s boss. They are just my patients. I expect that once I’m done with my recommendations they are discharged home to continue their infinite lives in good health…even those going home on hospice weirdly. But we humans are mortal and my patients do die.
I am used now to patients dying in front of me. I know how to make them comfortable, say the right things to family members in the room, to pronounce them DEAD, and fill out their death certificates. I won’t ever forget these patients who shared their last moments on earth with me.
But there’s just something unsettling about finding out about a patient’s death in an obituary even when I did send them home on hospice. And just like that, they are no longer the woman in the ICU with the recurrent line infection but rather Sally, mother of two and grandmother of one, married to her high school sweetheart, who loved to bake. No longer the unfortunate 21 yo man with complicated metastatic cancer but rather Joe, sweet Joe, valiant Joe, who was high school quarterback and was studying to be an architect. No longer that frequent flyer with poorly controlled diabetes who continues to smoke despite his emphysema but rather Herbert who in his youth was a volunteer firefighter.
Most recently, I’ve been bereaved of a lovely elderly man, who told me tenderly about his wife living in a dementia unit and shared with me the story behind his 1940s’ tattoo of the “woman with the big boobies”. We talked candidly about his fear that he may not survive the surgery. What did I say to him? I don’t actually remember. Even though I knew that the surgery was risky (though necessary) I just expected that I would see him again post-operatively. I really did. And I do see him actually, in that old man pushing his shopping cart in the supermarket and in the voice of the patient in the bed over.
My father once asked me how I coped with patient deaths when he overheard me answering a page from an ICU nurse who just wanted to let me know that the patient I was consulting on had just passed away. I shrugged then and said “I just do”. I wonder though, how do doctors cope with the death of their patients?
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