Friday, April 19, 2013

The other day.

"We'll need to discharge Ms. Pleasant early, I hope you don't mind. I know it's awful but it turns out that her son unexpectedly has passed away yesterday. She just found out and the family needs to get her home. Are you okay with going to see her before we round so that we can help expedite things for them?"

This is the first thing my resident said to me a couple of mornings ago. I take that back. First, she said "good morning" and then she said this. Her face was solemn and her eyes were filled with the quiet respect you offer at times of loss.

"Her child? He died?" I needed clarification. This woman wasn't far from my own mother's age so her "child" had to be an adult. But still. She wasn't old enough to be in that range of having kids who've crossed over into the "elder" designation. I knew that this son couldn't have been much older than me.

Or Deanna.

"Yes, ma'am," she confirmed.

Here's the thing. That day was only my second day on the service. This wasn't someone with whom I'd built a strong rapport or had gotten to know already. Her family hadn't shaken my hand or pulled me aside in hallways for questions. So this? This would be hard on multiple levels.

Multiple levels.

"Okay." That's pretty much all I said. Then I looked over at Jessica, the senior medical student on my team, and asked her if she would come with me. And perhaps when she obliged, she thought I was inviting her because it would be some kind of teachable moment. Maybe it would be, but really, I just wanted her there for support.

For me.

Surprisingly, I've been okay with watching people grieve since the passing of my sister. Though I believe my level of empathy and understanding have dramatically increased, my outward emotional reactions have become more contained. My touches and encounters with those who are hanging onto those tiny threads after gut-wrenching good-byes are approached with a new understanding. This is a walk that they will have to make. The new normal, unfortunately, must begin somewhere. So I do my best to be as intentional as possible about simply being present in their moment with them. Because I know that after that, regardless of how much love surrounds them, grieving is a very personal thing.


But this? This would be different. This wasn't a family who'd just lost a parent. This wasn't a long term couple with a half of a century of marriage behind them nearing the end of a long battle with some illness. This was a mother. A mother who'd just found out that her child--her child with life yet unlived--was now gone.

And so, with Jessica by my side, I approached the room. I could already feel my pulse quickening and some kind of strange emotion mounting inside of me. Before I could even get into the room, I encountered two women who identified themselves as her daughters. Which meant they were his siblings.

"My name is Dr. Manning. I'm the senior doctor on this team caring for your mother and I just learned of your loss. I know we haven't met, but I am deeply sorry."

And they both smiled and shook my hands and seemed appreciative.

Normally, I knock on a nearby wall and turn on the light switch as I enter. But not this time. The room was mostly dim. That seemed appropriate. It was overcast outside. My patient was sitting in a chair facing the window and those gray clouds. Something about that seemed to fit, too.

Carefully I approached while quietly acknowledging the other family members present. Once I reached her on the side of the bed, she slowly turned her head away from the window and looked at me. I knelt down before her and took one of her hands.

"Ms. Pleasant? I am so, so sorry to hear of your loss."

She nodded and tried her best to smile with those lost eyes. But she kept them on me. She did. Almost like she knew that I knew something. Or like she knew that I'd looked into eyes like hers before.

"There aren't any words I can say," I spoke softly, "There just aren't. But please know that I promise to pray for you by name, Ms. Pleasant. I will pray for your peace and for everyone who loves you and your son. I promise I will."

And I said that because it was true. I wanted her to know that I would do the thing that I thought I could do. And sure, not every person is a pray-er, but I am. So this is what I wanted her to know.

She seemed to appreciate that.

Then she deepened her gaze at me, eyes now brimming with tears, and something punched me hard in the center of the chest.  Hard, hard, hard in the chest. I'd seen these eyes before.


I squeezed her hand and stood to my feet. Taking a deep breath, I addressed the rest of the family. "Your loss deeply matters to us. It does. Your mother's health right now is okay for her to go home and we are taking care of getting the discharge paperwork, okay?" They murmured soft words of obligatory acknowledgment.

I needed to remove myself. The last thing I wanted to do is start crying in front of this grieving family.  No way, no how. So I gave condolences again and prepared to leave. Just as I did, I felt my feet sticking to the floor. There was more to say.

I looked over at Jessica, standing near the wall. Her hands were clasped in front of her in deference. I liked the way she respected this moment and I appreciated her being there. I did.

"Um, I just. . . wanted you to know. . . . I . . listen. . .my family experienced unexpected loss a few months ago. Um. . .my sister. . .yeah. . .well, she died last November." Something about that grabbed the attention of every person in the room including Jessica against that wall. It even moved Ms. Pleasant's eyes away from that dreary window scene. I immediately wondered whether or not I should have said this, but now it was too late. "She was less than two years older than me. And. .  . yeah. . . .I guess the reason I'm even telling you is because I just want you to know that I really am sorry. Sorry because there haven't been words that I have had to make my own mother feel better and also sorry because . . .  I'm just sorry you have to live through this."

That whole family was weeping when I said those words. And I swear to you, I was coaching myself with all of my might not to do the same. Something about telling them about Deanna seemed to fuse us all together. And, perhaps, this confluent grief made us one.

"I meant it when I said I would pray for you by name. And I will pray for each of you to know how to support your mother and each other. I promise that I will."

This time, I could tell that they believed me. And they should have because it was true.

I left that room and went into our team room where my resident, interns and other students were waiting. None of them knew before then that I'd lost my older sister just five months before. But since I could no longer contain my mounting emotion, I had to let them know right then and there.

I sure did.

And so I wept. Hard. And I told them all of this extraordinary human being I grew up with and how seeing Ms. Pleasant with those eyes reminded me of November 16, 2012 when I put my arms around my own mother and then made her go get back in bed. They were gracious and patient with me.  They were.

And it was only my second day on the service.

Here is what I know. I know that this will happen sometimes. I know that people are kind--they are--and that it's okay to cry on some days even in front of those same kind people and to be patient with myself when I do. I know that my friend Nancy who lost her beautiful daughter Nicole told me that for the rest of my life Deanna's spirit will walk into rooms and sometimes catch me off guard when I least expect it. And that some parts of that experience will rise up mighty and collapse me sometimes and to just be tender to myself when they do. I know for sure that she was right about that. All of that.

Yeah.  So the other day, my grief overlapped that of another. And I'm thinking that sometimes it helps everyone just a little bit when that happens. That's what happened to me on wards the other day. And my guess is that it won't be the last time it does.

No, it will not.

Happy Friday.


  1. Your are His hands, His voice, His love in this situation. God bless you and your entire staff and your family.

  2. And now I'm trying not to weep. ((hug hug hug))

    1. It's okay. I know you're pregnant and hormonal. :) Thanks for the triple hug. Got it.

  3. No it will not be the last time. You know one good thing about getting older? We become more and more part of the human race as our experiences become more and more the essentially human experiences.
    Love you, baby.

    1. You know what? This is so, so true. The essentially human experiences. Yes, yes, and yes.

      Love you, too, Sister Moon.

  4. You made me weep.

    I've walked into patients' rooms before and have been caught off guard by the spirits of my own lost loved ones.

    I only wish that I could have expressed my profound empathy for the families as delicately as you did.

    I'm so sorry that you have to live through that loss.

    1. For what it's worth, Kate, something about the way you've written this comment was both elegant and empathic. I bet you've done more for those patients than you realized.

  5. "Regardless of how much love surrounds them, grieving is a very personal thing." I couldn't agree more Kim. Grief, definitely teaches you how to handle another persons pain. Grief extends an advance course in life that no textbook or university professor could ever teach. Glad God strategically placed you in a field, at Grady "for such a time as this", it speaks to the testament that He can surely trust you!

  6. Thank you Dr. Manning...
    As one of the many who've been on this journey with you virtually, I can not tell you how much your sharing about Deanna has blessed me. Thank you for every time you decide to open up your life to us.
    I'm studying your reactions and thoughts because I want to be there for others, in any way necessary to support anyone who is hurting...
    You mentioned brilliantly that your experience has given you greater empathy and your emotional reactions have been more reserved...solely for the purpose of understanding, can you give some insight into why your are more reserved?
    Again, thank you and I will pray for your patient and her family. I'll continue to lift you and your family up in prayer as well.
    Many many hugs your way:)

    1. Hello, my friend. Thanks for these kind words--really.

      Hmmm. To answer your question, I think I'm more restrained because I feel more true empathy than sympathy. It's hard to explain. It's like, I know what it feels like to be the griever and I know how much silence and . . .just not trying too hard. . .yeah. . .how much that always made me feel peaceful. Too many words, too much heaviness just made me anxious and more upset. It's such a personal walk so being more restrained also gives the person space to be where they're at and gives me time to see what they need from me. If the space is all filled up with words and exaggerated deeds, that may not happen. I don't know. I think I just give people more space, I think. It's not like i'm trying, you know? Something changed in me. I think my eyes and my touch say more now. So my mouth has to say less.

      I hope this makes sense. I deeply, deeply appreciate you being a part of my community. You are a part of my healing process and I'm glad you read my words and thoughts.

  7. "It's such a personal walk so being more restrained also gives the person space to be where they're at and gives me time to see what they need from me".

    Wow. Yes, friend, this so makes sense. This is a lesson I will *never* forget. Sometimes when another person is grieving, even though our heart may be full with the best of intentions, we *assume* we know what the person needs to hear, when in reality sometimes doing less is actually doing more.

    Although by nature I'm much more of an observer than a talker, I am 100% positive that I've been guilty of "trying too hard" in an effort to be a source of comfort to someone. From reading your post, I've made a personal commitment to listen even more when someone is hurting so that I can greater respect their personal process. Thank you for being used to both mature my empathy and give me greater understanding.

    This takes me back to a previous post where you "unpacked" about the misjudgments from others on your reactions to Deanna's passing. The danger of presumption...yea, as humans, sometimes we are *so* off and we totally and completely miss it...

    I don't consider myself to be a "religious" person...but your thoughtful explanation reminds me of a passage I've read in James -- "let every man be swift to hear and slow to speak". You are a true teacher in every sense of the word. I sincerely thank you for just allowing us to be a part of your journey:)

    (Sorry this is so long!)

    Your friend,
    Elle (anonymous @ 5:47p)

  8. If your intention is always to "do no harm", then the Holy Spirit and the spirits of those who have passed will lead you to share when it is appropriate. Sharing loss and grief to those that are grieving doesn't add to their pain, but is healing to their loss.

    A few weeks ago I was present at the death of my best friends mother. It was just me and her two daughters, in her home, no machines (except oxygen), her dog on her bed. It truly was the most peaceful and loving passing I have ever seen. I hope to see it many more times in my lifetime. The love and compassion that we share with those that are dying and those that are living with death makes all the difference in the world. I then had to officiate at her funeral on Monday. It wasn't easy, but it wasn't hard, because of all the love. Love just makes everything feel a little bit better.

    It ain't fair that Deanna died and you will never ever be the same, but I am thankful that you are sharing your loss and love with us and everyone in your path because it does make it just a little bit easier, lightens our load a wee bit and the comfort that this road of grief is long, but we do not walk it alone.

  9. "...for the rest of my life Deanna's spirit will walk into rooms and sometimes catch me off guard when I least expect it. And that some parts of that experience will rise up mighty and collapse me sometimes and to just be tender to myself when they do."

    Thank you. I sure did need this today. Thank you.


"Tell me something good. . . tell me that you like it, yeah." ~ Chaka Khan

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