Using a chronological approach, I gave them a clear picture of the events leading up to the death of their beloved wife and mother. It was very scientific, very accurate. When I began to explain how the refractory thrombocytopenia had led to the intracerebral hemorrhage, her husband lowered his face into his hands.
“Stop. Just stop,” he said. His broad, hunched shoulders began to shake as low sobs escaped between short intakes of breath. “I don’t want to hear any more.”
It was not until that very moment that I understood. My patient’s family did not want to know “what happened.” My patient’s family wanted to know how their loved one had died. I suddenly realized that I had not told them what they so desperately needed to know. Unfortunately, the time for effective communication had already passed.
In a regrettable moment of highly literal thinking, I completely misinterpreted a very important question and forever ruined a moment that should have provided healing and closure. For many years, I blamed my own youth and inexperience. But as I myself have grown older, I am absolutely astounded that nobody ever bothered to provide me with the type of guidance that could have prevented this error. In fact, emotional distance and clinical detachment were the only guidance I ever received. I was pretty good at that, I am sorry to say.
And so in honor of my patient and her family, so many years too late, I will tell you how she died. She died exactly as she had lived, with self-deprecating humor and concern for everyone but herself. Though her face began to weaken, her brilliant smile did not dim. Though she understood that her own life was slipping away, she considered others first — she told me not to worry, cracking jokes to make me smile as I jogged through the corridors, pushing her gurney, rushing her to the scanner on the way to the ICU. Did I mention that she slipped away peacefully and that she wasn’t in any pain? Did I tell you that we did everything that could have been done to save her? I finally learned how to answer the real question with words my patient’s grieving family needed to hear. What happened? She died well.