My last post was long ago; just life getting in the way, I assume. My New Year's resolution is to be more consistent. This post, like my first, will involve a topic that we rarely want to discuss - loss. The Christmas holidays have become bitter sweet for me these past few years. Essentially, over the course of the 12 days of Christmas, an uncle (colon cancer), my best friend's mother (uterine cancer), and my grandfather all passed away in the winter of 2001 just after the 9/11 attacks. It had been a somber fall and it only got worse. I had only 4 uncles, and 3 have now had cancer, two of whom have passed away. I would have to say that the few adult men in my life growing up were an exceptional group. Maybe this is just the haze of a happier youth. Everyone has his/her issues, and my uncles were no different. But, they provided me, along with my father, the basis for how I approach my life in so many respects today. My friend's mother might as well have been my second mother. I spent virtually every day at his house in high school. She never, ever in my memory, had a cross word to say about anyone or anything. She very much enjoyed a creative spirit. She was one of the most beautiful people I have ever known. My grandfather lived a long life, but his death was actually somewhat unexpected. These people hang with me in the background, for the most part, with the occasional event that reminds me how strongly embedded within each other we all are. This year, however, they have been with me all too clearly.
A patient of mine died just before Christmas. He was 5 years old and had many medical problems. He had had an infection as an infant and so he was very developmentally delayed. He could not see or talk or walk. He also had a seizure disorder and more than one endocrine issue. One would think that his death was inevitable. That may have been true, but at this point it was very unexpected. I went to his wake. I have been to the wakes or funerals of all of the patients who have died in my clinic since I became an attending. This is, happily, not as big a task as one might think. My clinic is small and very specialized, and there have only been three deaths since I started almost 8 years ago. The first two were very much expected.
The funeral home was full. It was like any other, reminding me of scenes from David Lynch's 'Twin Peaks'. It was of some comfort to me that there were so many people there to help his mother. Despite the fact that he could not communicate or interact as most of us do, he had shaped her life for the past five years. She was distraught. There was no indication that he would die at this point, but I also detected that feeling of guilty relief, that only someone who has taken care of a person with a chronic, debilitating illness would understand. The service was largely in Spanish, and the Priest spoke so quickly that I understood very little. My mind wandered through the years and the time that I had spent in such places. What emerged was a reaffirmation of a principle that I had become fond of long ago in a different context - interdependence.
Our connections are strong. Call it love, call it the God within, call it whatever is comfortable, but the truth is, we need human contact and relationships to thrive. That is interdependence. I used to enjoy the books of Carlos Castaneda, but there came a moment when he advocated removing oneself entirely from the world. I found this proposition uncomfortable, for no matter how much time I need to spend on my own, I always go back to others. Maybe I took his premise too literally at the time. He could have meant that one needed to shut out the distractions to truly experience the divine, but this is not how the prose was written. So, my patient reminded me not of the inevitability of death, but of the enduring nature of our connections and the need to foster them. Maybe, in this time of 'change', we should renew our relationships and re-invest in the people who have helped make us who we are.
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