I am touched by the sensitivity of this doctor. Here as an article with pearls of wisdom.


Sep 13, 2012, 12:01 AM
The Widow’s Doctor Visit

I walked into the examination room and saw her sitting there, her arm around her 10-year-old son, her teenage daughter across the room.

“Hey, guys!” I greeted them, probably too loudly. I sat down and asked the children about school and their friends, until we circled around to talking about their father.

“We wanted to come to get some closure,” their mother said. “I talked it over with the kids, and we all decided this would be a good thing to do.”

Like most of these calls, this one came a few months after my patient had died. So far they have all come from women, almost always a wife.

A former wife, now a widow.

I specialize in treating leukemia, and entered my profession fully aware of the grim statistics: Approximately 7 out of 10 people I meet will die from complications of their disease. I always send a card to the family after a patient dies, reflecting on how that person made so many lives better, including my own. I offer any help I could possibly provide, which sounds anemic, I know, because the help I gave in the past clearly wasn’t enough.

This patient’s widow had arranged the meeting for a Friday morning in early April, when her children could also be there. She was in her 40s, and she had always come to earlier appointments with her husband prepared, with questions and medications organized. I could tell they were close, the way they sat holding hands whenever I met with them. His leukemia, which was particularly aggressive, shrugged off the best of our chemotherapy, and he died two days before Christmas.

At these visits, the agenda varies. Often widows come asking, “What if?” What if the leukemia had been diagnosed earlier? What if the infection had been treated faster? These questions are not accusatory but stem from what, I assume, is a need to revisit earlier events, in the desperate hope of changing the outcome.

The question they really want to ask is, “What more could I have done to prevent this?”

I try to reassure and support them. One patient, a minister, commented that my job was “pastoral.” I tell these women that they did everything humanly possible, that their husbands were lucky to have such supportive wives.

And most importantly, I try to offer them forgiveness.

I addressed the children, asking them if they felt all right coming here, if maybe they had also kind of dreaded it. We talked about what a terrible disease their father had, and how, despite all the medicines we tried, it still proved even more awful than we thought. I told them how proud their father was of both of them.

The boy’s eyes began to water, and he grabbed a tissue box. “Allergies,” he said, blowing his nose. “They’re really bad this year.”

I looked down and noticed his shoes. “You know, you’re wearing the same Sperry Top-Siders as your dad. You must be a fancy dresser like him!”

“He got his sense of style from his father, for sure!” his mother said. Her son gave us a half smile.

I asked them what they had told their friends about their father. The daughter answered, describing in highly technical terms her father’s diagnosis and therapies, and eventually his demise.

“Wow! You sound like you’re ready to be a doctor,” I said. “When can you start work?”

“Actually, she is thinking of becoming a doctor,” her mother said. The girl beamed.

“I’m just going to say this, in case you both were wondering,” I started. “It’s O.K. to be relieved that your dad has died, meaning that you don’t have to worry about him being sick, and hear about his leukemia at the dinner table every night. It doesn’t mean you don’t love him to be a little bit glad that his medical problems aren’t the focus of your lives anymore.”

The daughter nodded vigorously. Her brother quietly sobbed. His mother rubbed his back and pulled him closer.

“Their father wanted us to go on a trip to the Florida Keys, but we couldn’t get away when he was sick, so the kids and I went over spring break,” she said. “To honor him.”

Her daughter piped up: “The day we got there, I lay in a hammock by the water, and I looked down and saw this empty glass bottle with a cork in it.”

“A bottle with a cork,” her mother echoed. “Can you believe it?”

“We wrote a letter to my dad,” the girl went on. “And put it into the bottle and threw it in the water.”

“And then what happened?” the woman asked, looking at her son.

“It came back,” he answered, smiling. “We threw it in, and the water brought it back.”

“Your dad wasn’t letting you off that easy, was he?” I asked.

“That’s exactly right!” their mother almost shouted. The children laughed this time.

“We had to throw it back in. And this time it stayed,” the boy said. “It stayed.”

The room grew quiet as we thought about the way the water had embraced the bottle, as if accepting the words they had written to their father.

As we stood up to hug one another goodbye, I tried to figure out what had just happened. I felt as if a weight had been lifted from my own shoulders. When one of my patients dies, I ask myself a thousand times over what I could have done better. I hope that makes me a better doctor for my next patient. I suddenly realized that I had been deeply worried about this patient’s family, that maybe they felt I hadn’t done enough for him.

I guess I needed to be forgiven just as much as they did.

Dr. Mikkael Sekeres is director of the leukemia program at the Cleveland Clinic.