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Elegy For My Patients

Posted by Dr. Suzanne Koven  May 2, 2012 04:55 AM

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angel-of-grief.jpegLike many of my medical school classmates I'd decided against a career in pediatrics even before setting foot on the children's ward. "Who could bear to see a child sick...or die?" we asked ourselves--most of us knowing that we couldn't.

Over 20 years later I have seen many patients die. Most of them have been old, their deaths not tragedies, not crimes against nature--but still losses.

Sometimes, when I can't sleep at night, I think of them, one by one:

There was Mary, my first. I once wrote about her here. Irritable, angry, and alone, she reached for me--the new student--in the moments before her death.

And Tom, that hale jokester with the enormous white eyebrows and beefy handshake, reduced to skin and painful bones by metastatic prostate cancer.

And May and Mac, a couple so close they died the same day in the same nursing home.

And, most recently, Katie, at 94. At that age, and single with no children, you'd have thought there wouldn't be much of a crowd at the funeral. But the church was full. They'd run out of programs by the time I arrived two minutes early for the 10 o'clock service.

What had drawn them there? Her warmth, her megawatt smile, her strength. She'd served as a WAC in WW II, missed no opportunity to travel, and lived on her own until her final illness. She never did get the hang of being a patient. When I asked Katie how she was, she answered minimally and then asked me: "And how are you, dear?"

What had drawn me to Katie's funeral on a bright spring morning? Doctors going to patients' funerals is less common and more controversial than you'd think. Doctors, it's postulated, have an unusually high level of anxiety about death.

I went because of my fondness for Katie, of course, and to pay my respects to the devoted niece who'd brought her to every appointment.

But mostly, I know, I went for myself. Receiving the news of Katie's not unexpected death by phone had left me with a sensation of incompleteness, as if a part of me had been severed, its edges left raw and unsealed. How to make sense of Katie no longer being and my still being, bustling in and out of the same exam rooms where I'd seen her so many times?

I thought of Allen Ginsberg's poem Kaddish, in memory of his mother.

Strange now to think of you, gone without corsets & eyes, while I walk on
the sunny pavement of Greenwich Village.
downtown Manhattan, clear winter noon, and I've been up all night, talking,
talking, reading the Kaddish aloud, listening to Ray Charles blues
shout blind on the phonograph
the rhythm the rhythm--and your memory in my head three years after--
And read Adonais' last triumphant stanzas aloud--wept, realizing
how we suffer--
And how Death is that remedy all singers dream of, sing, remember,
prophesy as in the Hebrew Anthem, or the Buddhist Book of An-
swers--and my own imagination of a withered leaf--at dawn--
Dreaming back thru life, Your time--and mine accelerating toward Apoca-
lypse

After the funeral there was nothing left to do but walk out into the sunshine, and go back to work.

This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »

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