Sunday, September 7, 2008

Essay - Condolence Note After a Death Difficult for Doctors - NYTimes.com

Condolences, Felt but Not Expressed

By KENT SEPKOWITZ, M.D

Not long ago, soon after we put our pet dog to sleep, I received a handwritten note from our veterinarian expressing her condolences. The letter was not brief — she described my children's fondness for little Rudy and how caring they were as his condition worsened. It was thoughtful and personalized, not something she had simply dashed off.

In contrast, during my 25 years of caring for humans I have written only a handful of similar notes to families after a loved one's death.

This difference struck me again recently when the father of an acquaintance died in my hospital. He was a lovable guy, very much himself at all times, no matter the physical wreck he became as cancer progressively cornered him. He spoke with the same shrewd but amused tone even when in pain, insisting that we discuss only the important facts, not a bunch of medical baloney — facts about the Knicks or what was showing at the Guggenheim, whether the latest Tom Hanks movie was any good and did my wife like to cook?

Since his death, I have intended to write his family a note. But I haven't, and I suspect I never will. My hesitancy, compared with the graciousness of my vet, has led me to wonder where I have gone wrong.

In my defense, surely there are basic differences between the vet's situation and my own: responding to a dying, then dead, pet does seem less involved than the struggle against human mortality. And given the likelihood we would buy a new dog, it may just be good business to drop a few words. Or perhaps the explanation is nothing more complicated than the usual: doctors are blowhards, too self-important to bother to scribble the note, too lazy, too smug.

I doubt it is any of these reasons. Rather, I think doctors have a strange way of grieving their patients.

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http://www.nytimes.com/2008/08/12/health/12essa.html?_r=1&oref=slogin&ref=views&pagewanted=print