On the way to the funeral you wonder how you’ll be received by the grieving. Although you are confident that your care for the deceased was sincere, professional, and adept, you still question if others will so assume. There is silence in the car. This is a trip you make alone.
You manage a bitter smile as you recall stories the patient shared in unguarded moments, behind the door of a small examining room. How he beamed with content at the thought of his grandchildren; how her eyes glowed as she remembered the view from the Eiffel Tower; how the tears and sobs and memories of a lost child wracked his otherwise impenetrable façade. Sometimes you knew his spirit as well as you knew his medical illnesses, and often he hoped you would tend more to the former.
You walk into the funeral space. Many people are gathered. You sense pockets of light humor and recalled happiness amid dark clouds of sadness and gloom. Although you know this is not about you, your ego can’t help assessing how others perceive you. Most of those present barely notice, but others recognize you. Is it surprise registering in a few faces – that you’ve come to observe your patient’s defeat, that you’re emotionally invested in the person who once called you their doctor, or that you’re willing to dirty your powerful white coat with the stains of ultimate impotence? Or is it gratitude, that even in this darkest of reflective hours you’ve come to pay your respect to another who trusted you, confided in you, and who reached out to you for whatever healing you might bring?
As you shake the warm and cold hands of family and friends, you are reminded of the wide, verdant, chaotic world that existed outside the person’s small doctor-patient relationship.
It’s not just the hubris of the doctor that defines death as defeat. Very few persons seek out a physician to help them die well, at least in the beginning. And even when it is apparent that Time has overpowered us, it is only very late that we let go of the spiraling merry-go-round.
As you approach the coffin you are keenly aware of your own mortality, and yet in a state of denial. You think that your purpose is to mediate between life and death for others, and that somehow you exist in a space between. But as you bow your head in front of the lifeless body, placed serenely into its luxurious coffin, you are reminded of your illusions. You hear the sniffling misery, taste the salty ocean, and glimpse to where you’ll return.
You bid the family well, express your genuine sympathy, and leave. The air never tastes fresher, sweeter, more living than it does outside a funeral.
Back in the office you must move on. You have hundreds, thousands of other patients forming a queue that you imagine stretches across the fabric of the community. You are indispensable, and worthless.
But before moving on, you study the deceased patient’s chart one more time. It is certainly not literature, but if you read between the lines you can find poetry. You retire another legend of the examining room, slinging a stethoscope around your neck as you knock on the next door, hoping to be of some service while you too struggle on.
Beautifully written. Moving and inspiring!
I agree with Kendra. Take care.
You bring me to tears. You write so beautifully. That’s the kind of writing I remember when I first found you. You just touch a chord within us all.
I don’t see death as a defeat. I see it as being free, it’s a victory. No more limitations, no more pain, no more obligations, no more bills, no more rushing, no more earthly frustrations. A beautiful thing. Finding yourself weightless and free – behind the veil.
How will they see you? They will know you cared. What a great thing to let them know.
When a doctor is also a poet, there is so much beauty and pain. Your patients are not just flesh and blood, lab reports, and x-rays. They are their dreams and secrets, loves and passions, fears and triumphs. The poetic doctor knows and tends to it all. The funeral is the final dance, and you are a remarkable man for being there and knowing.
Thank you for reading, and for the kind encouragement.
Beautifully written.
How will they see you? Deep down inside, they will have a great sense of gratitude. Take care.
My mother’s doctor came to her funeral and it touched me so very deeply that he cared that much for her. I thought that he was the only doctor who did that until now. It’s just nice to know that the ones who take care of us sometimes actually do care for us.
Many years ago when I was 20 years old, a friend of mine went home during the middle of the day only to find herself face to face with a burglar. She died from her injuries. She was 21 years old. I still think about her now and again. I read your post earlier today and it brought up memories of that day when I heard the news of Kelly and then attending her funeral. We were all too young to really be facing the death of one of ours who was so very young, with her adult life just really beginning. Those of us who were her friends finished college, entered the work force, got married, all the things that people do that she never got to do.
As a physician, you have the opportunity to see into peoples lives because of the nature of your work. The life of a human being — well, I don’t imagine you can help but be touched somehow by another human being. I think most of us do not realize how difficult it can be for a physician caring for someone’s health but in the end, people/patients succumb to what all life will succumb to. I guess I never really thought about it.
The ER docs that worked on my friend — they never got to know her even briefly. She went to the ER unconscious with serious injuries and left the ER without her life. I can only imagine it was difficult for the ER docs to see someone so young and be unable to save her.
Beautifully written.
I am glad I found your blog again. I loved reading your stories. I added you to my feed list today.
A rare gem in the Blogosphere – thanks for sharing. The importance of the attendance at funerals of members of the caring profession cannot be emphasized enough. It truly demonstrates a continuum of care that does not end at death, but continues in a show of support for the survivors (family & friends) as well as honouring the final life milestone of a human being.
This was really beautifully written, thank you. When my friend died very young from lung cancer, while we were all in college, the entire team that treated him came to the funeral and it was incredibly moving and thoughtful.
Beautifully written. The patient story is such an integral part of medicine, and I believe that because you have taken the time to know your patients, not just their disease, you have made their lives better.
It is gratifying and inspiring to see a physician who cares so much about his patients, is so invested in their lives–and their fates–and who can express his thoughts so beautifully. I am the photographer who took the angel image.
drc – a special thanks to you! I forgot to credit your image directly. Beautiful shot.
I am freshly come from just such a funeral. Yes, a thousand times, yes, and thank you for expressing it so well.
Wow. So beautifully written, so moving.
I think if I were at the funeral, I might be surprised to see you there. Not because I thought you didn’t belong, but because I didn’t know doctors still had that kind of relationship with their patients anymore. What a blessing you are for your patients.
I found your blog via Grand Rounds, and I will definitely be returning.
so touching. even if the family and friends never express it, i am sure they will be filled with gratitude to have a doctor in the funeral of a loved one.
thanks for sharing your thoughts. may your tribe increase.
Just remember that your patients can not do what you do. They come to you for help, and instead of finding a cold clinician, they find a human being. Just as it’s obvious that you don’t find a patient so much as a person with hopes and dreams and a life. That you care that much speaks volumes. All patients should be fortunate enough to have a doctor like you. And anyone who would know you would know that you went to the funeral because you care. Dr. Seuss once said something like, “Be who you are and say what you feel because those who mind don’t matter and those who matter don’t mind.”