pediatric housecalls Robert R. Jarrett M.D. M.B.A. FAAP

A Patients Funeral

This is perhaps the most odd post I’ve written for this site in many years. It’s been on the possibles list for a year or so while I tried to figure out how to present it, and I’ve had difficulty.

I never respond with a comment on someone’s blog; but, when I read an article by another physician about going to a patient’s funeral it hit me so strong that I simply had to. Then the more I thought about it, I felt that both his article and my comment should find a place on my site as well.

Here is the original article written by a colleague.

Any suicide is tough to take.

The suicide of a young person, a teen ager, is especially difficult.

A parent is not supposed to lay their child to rest, let alone for this reason.

I have seen this tragedy play out in feeds on Facebook, in a nearby community, in my school district, and in my practice.

If you are reading this blog, it is because you have kids, teach kids, care for kids, like kids, or know kids. It also means you know their families or their friends. It means that you, too, have been touched by a suicide. And you are left stunned and speechless. What to do or say (if anything, you think)?

Some time ago, I decided to reach out to a family who had lost a child to suicide. There were other kids in the family they would continue to come to the practice. While I didn’t know the family extremely well, I knew them well enough. When I heard about the death, I wanted to reach out, and I dropped an approximation of the following letter in the basket of other cards at the viewing. I don’t know if it helped them, but I hope it did, because they need to know that their child’s life was and is important. The siblings need to know. The parents need to know.

And I need to try to make sense of things. Words help me do that.

I don’t think we, as pediatricians need to write a condolence letter every time a patient in our practice dies. But I think we can, and should, as an act of humanity and consideration. Pediatricians practice in the realm of the new and possible. We converse in the areas of hope and potential. Death is not a frequent visitor. But when it does touch our lives we shouldn’t be dissuadeds from acknowledging that our patients also touch and affect us, that they leave impressions on us, and that they and their families give us meaning and purpose. We celebrate the success of our families and their children. We can mourn with them, too.

To the family of “Jane D,”

I wish to convey to you my deepest condolences for your loss. Jane’s departure from this world leaves a void, an anguished desire for meaning, and a pang for lost days. There are no words that can fill this void or return Jane to our grasp, but there are words that have been shared with me, almost thirteen years ago, that I would like to share with you.

My colleague, “John”, lived next door to me when we were young physicians. Our family shared meals together, our children played with each other, and he was my friend. None of us knew, however, the demons that weighed on his heart. The darkness from which these demons emerged to torment his mind got the better of John. He intentionally took his life, having carefully collected the components of a lethal pharmacological cocktail, on a Friday afternoon.

At his funeral, the pastor, who did not know John, spoke to his wife, his school age children, and his friends. She shared with all of us the thoughts I will try to share with you. I occasionally ponder these words, not because that have brought John back, but because they help me find meaning and even hope.

First, you are not responsible for Jane’s death. The darkness that enveloped Jane was unfathomable. It was consuming. It was impenetrable by our actions or words, even those of a mother or a father or a sibling or a grandparent. Jane’s demons were not of your making. The darkness was not your creation. I pray you find in your heart the forgiveness and release you deserve.

Second, Jane is now free from those forces. The darkness that proved so thick and pervasive no longer torments her. Her heart is no longer anguished. Jane is at peace now.

Third, as a person of faith, while I freely acknowledge that do not have all or even many of the answers, I do believe, to the very core of my being, that with God, all things are possible (Matthew 9: 26). I don’t know how, but I do know why; because Jane was brought into our lives for a purpose. She snuggled with you as a toddler for a purpose. She sat in your lap or sang you a song or shared a laugh with you for a purpose. She brought you joy (and purpose) when you watched her play soccer and basketball. She made you laugh when you went to the beach or took trips up to the lake. Jane’s friends will tell you that she was kind to them, that she listened to them, that they will miss her. She has touched others and she will go on living in our hearts and minds. That is Jane’s purpose.

Finally, we are all tasked with taking in these events and, despite their leaden effects on our will to face each day, going forth. Jane’s ultimate purpose will be revealed when we share with others the pain and the loss we feel. There will be a moment, in a week or a month or a year, when we learn that someone else has suffered a similar loss. Here will be an opportunity to reach out and console. Here will be an opportunity to speak these words.

“You are not responsible.” “Your child is at peace.” “Your child’s life has purpose.”

I pray that you find a place in your heart where grief will give way to acceptance. I pray that you will again find hope. I pray that you will again find joy. I pray that you will be able to laugh…again…soon.

Be assured of my prayers for Jane, and for you and your family.

(Gregory Lawton, MD, )

After reading the article, then coming back to it a second time, I felt obligated to break my own rule and make a comment; not so much on his personal reason for writing it, for that cannot be added upon nor does it need a “second,” but about the “back story,” if you want to call it that… about a physicians act of caring.

Dear Doctor,

Reading your post I was touched. So much so I’m back a second time and feel I need to break by own rule of not making public comments on posts. Not on the reason behind why you wrote it for that is personal and actually needs no further comment; but, on the fact that you attended the funeral.

I too have gone to patients funerals, and to children that I’ve coached—gratefully, not many. But, frankly, I thought I was probably the only doctor who did. (You see, I’ve never met another who had; and, sadly, have met with some puzzled looks from others). I don’t comment about this for any attention; because now, like then, I really didn’t even think about it, I just did it, I’m a “doctor.”

I love the term. Like others I didn’t just pick up the degree off the street. I worked hard for it like most do and the whole time I was working for it I did so under a sort of… “protest,” for want of a better word, because I just kept thinking “let’s just get on with it! When do we start to ‘matter?’ When do we get to help?”

I love being called “doctor” – not because of what I know, or my circumstance; but because I get to “care” in a way that isn’t available to everyone. A kind of caring that people don’t allow those without the title do for them.

They show me things, tell me things and in other ways let me “in” to their world, which they otherwise wouldn’t do. And caring somehow makes me, I don’t know the right word… whole, I guess, or “better than I was” at least in some way.

Sometime by sitting there at the service I’m saying: “I really wasn’t through knowing you yet”; Sometimes, “I’m going to miss our visits”; and sometimes “I’m so sorry I didn’t get to help you, I truly would have if I could.”

I’m a bit relieved now to know that I’m not alone in the practice and I’m sure that just due to the mechanics of the circumstance we do the same things and perhaps even feel the same things. Intentionally I’m nearly always near the back, often alone and rarely recognized. Sometimes I too tuck a prewritten note into the guest book; but I always sign the book because, I suspect, after all the family and friends and bustle have gone, the books are always read… and I’d like them to know that I, too, care. And I’m glad that I got to be their doctor.

These days I spend much of my time as caregiver to my 96 and 91 year old parents and am coming to understand an aspect of my profession that I didn’t realize: not all physicians (especially the younger ones) feel the same things I do about being called “doctor.” Perhaps it’s because they’ve been called “healthcare provider” for so long; perhaps something else, I don’t know.

A lot of things have changed. Sometimes, just as for my parents, things are confusing to me because this is just not the world I grew up in anymore. Oh, I know overall it’s better now. But, all I can tell you is that so far I’ve sat in thousands of classes and meetings (maybe hundreds of thousands) and definitely seen thousands of patients; but, unfortunately for me, as I turn more and more to memories of my life, I actually remember the specifics of almost none of them. The things I can still write about in a memoir are the times that “caring” cost me something, in some way.

It may not be that way for other physicians; but, if it isn’t, I truly hope they have something to take its place which is at least as rewarding… satisfying… fulfilling for their lives. I’m grateful, and can’t help but feel blessed, that we now know and understand so much more than we did when I started this venture. In some things we now know enough to realize that we know less than we thought we did. But, with certainty, I’ll be happy to tell you what the venture thus far has taught me…

It’s no small thing, to find somebody who cares.


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