Musings of a Dinosaur

A Family Doctor in solo private practice; I may be going the way of the dinosaur, but I'm not dead yet.

Monday, September 03, 2007

Shattered Lives - Part Two

Six AM; getting ready for work; the phone rings. The son of a dear friend has shot himself. I suppress a gasp. An accident? "He's not going to make it." No. The friend's friend promises to call back later, and could I please call in something to the pharmacy for them. Of course I will.

I collapse in a chair for a moment, my fist in my mouth, trying to catch my breath; easier said than done over my racing heart. Or had it just stopped altogether?

One of my dearest friends has just joined that most unwanted of clubs: she has lost a child. Twenty years old; the same age as my twins; by his own hand. Or has she? Was he actually gone yet? Was there a chance he just might still make it? Or had he been pronounced at the scene? My insides are roiling. It's all I can do to function at work, waiting for the call.

The only way to deal with patients is to forcibly push the thoughts from my mind. Then, every few hours, I feel guilty as hell for not having thought about it. Where are they now? What's happening? All accompanied by that heaviness of heart that sinks right down to the stomach and just sits there, like undigested food I never ate in the first place.

The call came about half an hour before closing. He was gone. He had been depressed for a long time, but had just promised to go back to counseling. I didn't ask where he'd gotten the gun. It happened in the middle of the night. He had been airlifted to the regional trauma center where he'd been declared brain dead, but kept on life support so his sisters could come say goodbye and his organs could be harvested. They had just gotten back from the hospital. No arrangements had been made yet. She'd call tomorrow and let us know.

There was no point in asking how she was doing. She sounded exhausted and numb. As I hung up, the tears that had been welling up as she spoke finally spilled over, and I sat alone in the empty office for a few minutes, sobbing. Again, part of the misery was the feeling of fraud: my kids were fine. Guiltily, I blew my nose and headed for home, filled with melancholy. A pall of sadness hung over my every thought, although I realized my emotions were but a pale echo of my friend's. I both could and couldn't imagine what she must be going through.

Somehow I got through the rest of the week without seeing her.

I called. She was staying at one of her sisters' along with the rest of her family. She couldn't bear to go back to the house yet. She invited me to come out before I could ask, and I was grateful. I needed to see her, even though I knew by definition there was nothing I could do.

The house was crowded with people and thick with cigarette smoke. It was not the time for a tobacco intervention. They all knew I was a doc, so they asked me to help out with my friend's mother, who had broken out with shingles. Her regular doc's response -- after two days and numerous unanswered calls -- was "go to the ER", so after eyeballing the rash to confirm the diagnosis I called in an antiviral and some pain meds, "Just to get through the funeral." It was an exception I was happy to make.

The older sister was inconsolable. I held her as she sobbed against my shoulder. The brother was angry and not handling it well at all. The younger sister held it all in, as did the father. They were still just numb.

I found my friend on the deck by the pool. They made room for me to sit next to her. I held her for a moment, and then just sat. Her eyes were empty. Details flowed: the last day; the shot; the hospital; the transplant team; the final goodbyes; the arrangements so far. Tears flowed, were dried, and then flowed some more. Raw emotions washed over me as I sat there, telling myself that was all I needed to do. There were no right words and a million wrong ones, which I tried not to say.

That young man may have shot himself in the head, but the bullet tore through the hearts of his family at the same time, changing them forever even as it destroyed his brain. Oh, parts of his body will live on, a testament to his mother's determination to find whatever "good" could possibly be had from tragedy. But the pain of just witnessing this kind of pain is intense. There's nothing for them to do but feel it, and nothing for the rest of us to do but feel it along with them.

Time is both friend and enemy. Enemy, because the funeral isn't until next week. Until then the limbo continues. The viewing and burial will be at least a public version of "closure", although everyone knows there's no such thing. Still, it's a necessary event to "get through" as it looms ahead, welcome and dreaded at the same time. Friend, in that the only thing that will lessen -- not eliminate -- the pain will be time. One day at a time; bad ones with rare good ones interspersed. With grace, eventually that ratio will flip. But it's not yet time to talk about things like that. Not just "one day at a time" but "one minute at a time" is the watchword for now. All I can do is be there. And I will; pain and all.


At Mon Sep 03, 08:33:00 PM, Blogger Dr. Rob said...

You have done an incredible job on this series of posts. Great writing and excellent job of bringing us in on the emotion.


At Mon Sep 03, 08:46:00 PM, Blogger Dr. Deb said...

This is so tragic. My heart aches whenever I hear of such things.

At Mon Sep 03, 08:54:00 PM, Blogger BillyBob said...

I'm sorry to hear of this tradgedy, but don't have guilt even for a split second that your kids are fine. Life is fragile, and short, and full of suprises. Grateful, yes, but never guilty.

At Mon Sep 03, 08:58:00 PM, Anonymous Anonymous said...

Terriby sad. Thanks for memorializing this tragedy with such great and sensitive writing.

At Mon Sep 03, 09:38:00 PM, Anonymous Anonymous said...

I'm so sorry.

At Mon Sep 03, 10:58:00 PM, Blogger Margaret Polaneczky, MD (aka TBTAM) said...

Such a tragedy for your friend and her family, and for you. I am so sorry.

At Tue Sep 04, 12:18:00 AM, Blogger woolywoman said...

I am so sorry, for your friend, for you, for all of us, realy. Who knows what he may have become? Perhaps your words will help someone who is on the edge to see that their death will hurt those who love them. Thank you for writing so eloquently about such a difficult subject.

At Tue Sep 04, 01:42:00 AM, Anonymous Anonymous said...

Great series of posts, that really struck home. Both my husband and I have struggled with major depression most of our lives. Each of us has come closer than anyone should to taking our own lives - and frankly, the only thing that prevented me for a long time was what it would do to my son. I was lucky - too many people who suffer from this disease are in such pain that they lose sight of how they affect the people around them. The belief that you are so worthless is so deep that it is easy to believe your loved ones will be better off without you. It isn't rational, I know, but that is the scary thing about mental illness - it *feels* rational. I hope your friend and her family, especially the young man's brother, can understand that he didn't do this to hurt them - he did it because he thought it would stop *his* hurt.

At Tue Sep 04, 01:45:00 AM, Blogger The Tundra PA said...

Beautifully written, Dino. My heart goes out to you, to your friend and her family. I am so sorry he was unable to get the help he needed. Thank you for sharing this pain filled experience with us.

At Tue Sep 04, 08:51:00 AM, Anonymous Anonymous said...

and frankly, the only thing that prevented me for a long time was what it would do to my son

Thanks for posting that comment. Glad I'm not the only one to feel that.

And thanks for raising the topic, Dr. Dino.

At Tue Sep 04, 09:20:00 AM, Blogger rlbates said...

Another great post on a very difficult topic.

At Tue Sep 04, 09:05:00 PM, Anonymous Anonymous said...

Suicide is so damned hard. The question is always there, no matter what we know about a person's situation - why? Alas, only they know for sure.

As for the funeral, that's the easy part. The hard part is learning to live without them.

Take care.

At Wed Sep 05, 12:07:00 PM, Anonymous Anonymous said...

It's series like these that make reading blogs worthwhile.

Dino, these entries have touched me incredibly for reasons I will not explain.

It seems that folks who blog frequently create a sort of persona; They tend to represent an ideal version of their self for public consumption. If you are half the doc that you portray in this forum-- and I believe that you are-- your patients, and family, are truly lucky.

Sorry for the disjointed comment, but I had to say it.

At Sat Sep 08, 12:53:00 AM, Blogger SeaSpray said...

Dear Dr Dino -I am so sorry for all of you that this happened. They are blessed to have you for a friend. It's the months after the funeral when everything gets quiet and the calls and cards stop that your friendship will be appreciated more than ever.

At Sat Sep 08, 12:00:00 PM, Blogger Alexis said...

About seven years ago, sitting shiva with friends, I heard this phrase in abundance (and didn't understand it, as I was a mere interloper, though I soon learned). Now, I think it's for you:

HaMakom Yenachem Et'chem B'toch She'ar Aveilei Tziyon Vi' Yerushalayim

At Sat Sep 08, 08:41:00 PM, Blogger Hygeian said...

That is so very sad. I am really thankful that you're writing about it though. After the many suicides on my campus last year, I felt that it got very quickly brushed under the rug. I could see some of my students were aching and it hurt to know that there is too often no outlet for speaking about such grief. Thank you for that, and I am very sorry.

At Sun Sep 09, 12:07:00 AM, Blogger janemariemd said...

These are wonderful posts, near-perfect and ohsomoving! I'm in awe Dr. Dinosaur ...just keep writing, please!

At Fri Sep 21, 12:49:00 AM, Anonymous Anonymous said...

The wounds caused by depression and suicide are more insidious than the ones we can see and bandage. If anybody is depressed and reading about this, please keep up the fight against your disease and don't let up on treatment. Yes it is a chronic disease, but so many of us are conquering it - take hope. Thanks for sharing your experience and your fine writing, Dr. Dinosaur.

At Sun Oct 21, 01:14:00 AM, Anonymous Anonymous said...

My best friend did the same thing to herself over 30 years ago, your sharing and the comments opened up the pain and anger of her loss once again, how I miss her and the life not lived, the songs not sung and the love not shared.....just another PA


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