I Told His Mother That He Wasn't Alone, He Wasn't Afraid And He Was Loved

My job as an emergency-room physician is strange, difficult and, above all, worthwhile.

02/26/2018 11:48 EST | Updated 02/26/2018 16:52 EST

Pouring through us, and over us — then, for a moment, we're flowing with it — then we're lost.

A man died today. Men die every day. Women, too, but this one we were almost there for. He lost vital signs on the ambulance stretcher a few minutes before his body arrived, and with them, a future.

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I told his mom. People don't expect to hear that kind of news, not once a child gets old enough to take care of himself, but there it was.

The bottom of her heart fell open, and the grief painted over me, the nurse, filled that small room until it was hard to breathe.

I left to take care of a few pieces of unfinished business, having learned something of the language of sadness after all this time, how certain people want to be alone with it for a minute, or didn't mind if I declared myself as one as long as I came back. I did some paperwork, called the coroner, returned to the quiet room and sat beside her, waited. After a few minutes, she looked up, a different person than the one who walked in.

We had that much in common, at least. I started to talk. I told her about my strange job, the view it offered, hovering near the end. I told her what I learned from my vantage, about last minutes. They seem so quiet. The mind quells, then the body. When you watch someone go through them, you taste a peace we only seem to know when returning to a true home.

I didn't say it because I thought she needed to hear it. I said it because it is the truth.

He wasn't alone.

He wasn't afraid.

He was loved.

She held my gaze for a second, tears shaking in the corners of her eyes, nodded, turned back to her hands.

I didn't say it because I thought she needed to hear it. I said it because it is the truth, and in those minutes, the truth is what counts. Same as all of them.

It's taken me some time to realize my work. I thought for so long it was about bodies, but it's not: it's about what happens between them. I am explicit about it with some of my patients if I think it will help, sometimes even say aloud:

"You and I are in a relationship now, it's called the doctor-patient relationship, and like any, it requires work. In it, I promise to work in your best interest with all the resources I can bring to bear, with as little bias as possible. My work, then, is to rid myself of bias. Cognitive ones, racial ones, the number of people wanting me to hurry outside this door, or make money from the encounter."

"Impossible as it is, I am willing to take it on, but need two equally difficult things from you. First, I need you to be as honest as you can be. I know it's not easy, because pain can be difficult to evoke with words, but if I don't know what to work on, or at least where to start, I'll never get it right. Second, I need you to take responsibility for your well-being. If you don't, whatever I pour into it, will just leak away. Sometimes it leaks away even if we both try, so the worth of the work must be its own end."

It doesn't always seem that way. It's difficult to see people on their worst day, especially if you've one of your own. People burn out on this medical job faster than any other. Some doctors even kill themselves, ashamed to not be able to hold the mask of their brave face in its perfect place. I'm not the same person I was when I started this job, but I wouldn't go back. Who even finishes a day the same person who opened their eyes in the morning? So much happens before a foot even hits the cold floor, so many connections made, pored over, it's astounding a minute ever seems short, let alone a life.

But when you're a mom who, fishing a slipper from beneath the bed, decided to ask your son over for dinner that weekend, and before it can happen, find yourself face to face with a stranger in a green gown searching for words of comfort after telling you such a dinner will never be, it isn't the brevity of life that bothers you. It's that even an instant without such a possibility seems forever too long.

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After she left, I gathered with the nurses who were with me when he arrived. We glanced at our watches, the urgency of the number of people waiting for our time, pulling at us. We didn't talk about what went right, or how we might do better next time, just what we were feeling. I said I felt a sadness that was going to stick around for a while. I'm glad we tried, someone said. We all nodded. I'm glad for all of you, someone else said.

We've started talking about these kind of things at work. It feels good to be honest. I'm discovering that I have more company than I ever knew, not just with the difficult things that can seem mine to bear alone, but in the many joys that seem part of this difficult, worthwhile work, that all humans share, how to live, how to love, how to let go.