Saturday, December 3, 2011

The Cost Of Closure

You know Mr Miller?

I adjusted the phone on my ear as I slipped out of bed and snuck into the bathroom. I tiptoed across the floor and winced as the old hardwood started to creek beneath my feet. I craned my head and listened for signs of stirring children.

Remembering the resident holding on the line, I whispered into the cell.

Yeah. What about him? He had a choleycystectomy this morning.

I waited impatiently. I suspected that Mr. Miller had spiked a fever or needed some changes in his pain medication. It was a naive moment. The moment before I was about to hear something awful.

He coded. We were unable to revive him!

The phone slipped from my shaking hand and crashed onto the floor.

Seconds later, my two year old daughter started to cry.


I immediately felt out of place as I entered the church. The suit clung uncomfortably and the tie was strangling. I meandered past the pews in the front, and found a seat in the rear of the room.

As the ceremony began, I marveled at how many people had shown up for Mr. Miller's funeral. I watched as men sat stoned face and women wept silently. I searched through the crowd, but couldn't find a single familiar face.

The preacher was standing at the lectern. I tried to concentrate on his words, but It was impossible. The sweat poured down my forehead and I started to tremble.

I couldn't shake the feeling that I let Mr. Miller down. That the medical community offered cure but delivered heartbreak instead.

How did we allow this healthy fifty year old to die?

I quietly extracted myself from the chair and left mid ceremony. A few heads turned as I walked down the center isle and exited through the ornate swinging doors.


Sadly, I've never attended another patients funeral. Mr Miller taught me that I don't have the emotional fortitude.

The covenant between doctor and patient is sacred. My commitment to my patients well being is absolute. I vow to stand by them in sickness and in health. I will support them when they are hurting and I will tend to them when they are broken.

And when they are dying, I will devotedly attempt to ease their pain and suffering. But then the commitment ends.

Sure, it would probably be more healthy to go to the funerals. It would be personally gratifying to mourn appropriately each and every time. But when you have a hundred people die a year, it can be emotionally exhausting.

Sometimes the cost of closure

is too great.


Lisa Fields said...


Thank you for giving us an accurate glimpse of what a caring physician experiences when a patient dies.

I"m not sure it would be healthier for you to attend every single funeral. We all are the experts of ourselves. Funeral also take time and the work load for physicians is so heavy it does not seem like it would be a realistic goal.

Perhaps the best way to honor the lives of your patients is to continue to give your patients what they need, spend time with your precious family, continue to study the most current literature and experience some down time so you have enough energy to give to each of your patients.

As Brian Vartabedian @doctor_V reminds us a Handwritten note is truly a remarkable act of kindness for those who have touched our lives. For those patients who have held a special place for you a short note to their family could give comfort for such a long time as they chose to read your words.

Thank you for your continued passion for medicine, your patients and for helping us each grow as we read your posts.


Jackie Fox said...

Don't beat yourself up over this. I think attending funerals would be an awful lot to expect from doctors and could deplete the emotional reserves you need for yourself, your family and your patients.

This is a great example of how important it is to "Know thyself."
You have one of the most emotionally honest voices in the blogosphere. I'm in awe.