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 person.

Doctors are pretty good at explaining the why’s of illness and death, but not very good at comforting the grieving.

“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 day again.