Attending to a Patient's Funeral

Doctors have a special relationship with death. In May, I wrote about the difficulties that Doctors and others have in their responsibilities to inform patients and families of death and the prognosis of death. Doctors also have a unique perspective on the aftermath of death because of their relationships with the deceased and the expectations of their role in prolonging life.

"Country Doctor" W. Eugene Smith 1948

I am very pleased to be able to share with you a post from The Examining Room of Dr. Charles. Dr. Charles is a physician who writes an insightful and informative blog about his experiences and perspectives, and he has graciously granted me permission to share this moving post on doctors and funerals.

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.

For more from Dr. Charles, please visit his blog at http://www.theexaminingroom.com/