Notes from an emergency room doctor: He was old
and frail, with the sunken eyes and distant stare
of someone near death.
The patient had long ago declared his wishes
to his family and physician. He wanted no tubes,
no respirators, and no heroics. He had even asked
to "die at home." But when the desperate
moments before death came, his family called paramedics,
and he was brought to the E.R.
Why did they not just keep him at home to die
in familiar and comfortable surroundings, with
family and friends who loved him by his beside,
rather than in a cold, impersonal hospital, amongst
strangers with distant, scientific, and mechanical
manners? To die at home was what he preferred.
"We couldn't stand by and do nothing,"
the family explained. But what they meant was
they could not cope with being that close to death.
As an emergency physician, I am not a novice
to death. I see it with all too much frequency
- because few people are allowed to die at home
nowadays. They are brought to hospitals to grasp
at a few more moments of life because of an often
unrealistic and almost fathomless faith that modern
medicine can cheat the grim reaper.
In the beginning of this century, most people
did die at home, surrounded by their families.
Back then, there were no cures for life-threatening
diseases like pneumonia, diphtheria, and tetanus.
Medicine was not recognized as being omnipotent.
People were more familiar with dying, and that
experience helped them accept death as a natural
part of life. Today, however, most people die
from diseases associated with aging. As a result,
about 95% of all children reach adulthood without
experiencing a death in their family. Most people
have never been present at someone's death. And
when death comes, it usually occurs in hospitals.
This lack of experience makes it difficult for
many to talk openly about death or be with a dying
Doctors are pretty good at explaining the why's
of illness and death, but not very good at comforting
"I'm sorry," we'll simply say. "He's
passed away." And a kind touch or a brief
hug may be all the comfort we have time to offer.
And truthfully, no one likes being around a grief-stricken
family. Their distress takes its own emotional
toll on outsiders.
Finding words of comfort are difficult. "He
didn't suffer," we'll say, trying to anesthetize
grief. Or, "he's in a better place,"
we'll say, reaching for a touch of spirituality.
But these often seem like empty words bouncing
off a barrier that exists between the grieving
and the unaffected.
Outsiders can try to ease the pain of those
who are grieving but each individual must adjust
to their personal loss in their own unique manner.
Some will need to weep; some will need privacy
and isolation to come to grips with their loss;
and some will need the support of friends. Religious
mourning rituals and funeral customs can be helpful
in easing grief. By participating in these practices,
regardless of our own personal beliefs, we can
help comfort those who are grieving.
There is no cure for grief. It is something
that must resolve itself. Grief is like a cold,
gloomy, rainy day. You may not like it, but you
know its part of life, and eventually you'll be
able to walk outside into a bright, warm, sunny