by Robert J. Lanz, LCSW
I can’t think of anything worse than discovering your mistakes by reading about them in the local newspaper. When that happens, by the time you get to work on the night shift everyone already knows about it before you do, unless you are the kind of compulsive guy who would drive across town and buy the local newspaper to check on those things before showing up for your shift. I wasn’t that kind of guy. I had more confidence than that. That is, I once had more confidence than that, and losing some of didn’t have anything to do with reading the newspaper. I found out there is an even more painful way to discover your mistakes than by reading about them, and this way made my worst nightmare a reality.
As soon as I got to work that afternoon, and before I had a chance to read the paper, one of the nurses told me there was a woman in Room 11 waiting to see me. She was totally distraught because someone had just murdered her best friend.
This is not going to be a good shift, I said to myself as I put my things away and walked into Room 11.
As I came through the door, the woman looked up and said, “Oh Bob, I’m so glad you’re here.” Her face was familiar but I couldn’t immediately place it. This is a common problem in my profession, and one I have had to cover for on many occasions. We are often face to face with people with whom we have spent hours—impending death hours, sad and gut wrenching hours, but three days later we can’t remember who they are. These people will never forget us because we were such a big part of one of their worst nights on earth. We forget them because we experience so many worst nights on earth that we can’t afford to go dragging them around with us. Just too heavy. But no matter what we do to protect ourselves, some of them get dragged around anyway.
It took a minute for recognition to sink in, and when it did, I was almost knocked over by it. I was embarrassed. I was angry. I was afraid. Had I done everything I could?
A few weeks earlier, the woman in Room 11 had accompanied her now dead friend on an ER visit necessitated by domestic violence. After having suffered some excruciating but unspecified abuse, the friend had decided to get out of the terrible relationship she had endured for so many years. She had finally moved out and was staying with the friend, but she couldn’t get any sleep and it was starting to affect her health. We talked a long time about what she needed to do next, how to protect herself and what she could do for safety. I remember emphasizing that when a woman lets a man know she is terminating their relationship, especially if there is some legal action; this is the most dangerous time of all. I remember telling them both vigorously exactly how dangerous the next few weeks would be and how important it was to get connected with a woman’s shelter and have some supportive counseling. I remember telling the friend she was also at risk for protecting the victim and that the husband might know where to come looking for his wife. Danger, danger, danger I emphasized. But it wasn’t enough.
“Oh, Bob. He killed her. He murdered her and ran away. I have her son with me and he’s safe but I can’t sleep and I can’t stop crying. I can’t stop crying.”
I knew I had to help her with that problem. The living one was my patient now, not her dead friend, the one I couldn’t stop thinking about. What went wrong? Hadn’t I made clear the potential dangers? Didn’t they believe me? I was suddenly so caught up in my own fear and pain, that for a minute I couldn’t focus on helping the patient with hers. Finally I snapped out of it, putting my issues away. I would take them out later when I had the energy and time to deal with them. Someone else needed me more than I needed me right now and there was work to be done.
We talked about her loss and we talked about the new responsibility she would have if she adopted her friend’s son. We talked about her rage toward her friend’s husband. After an hour or so, she thanked me. I got her some medicine so she could get some sleep and find a temporary place to feel nothing for a while. That’s what she needed to do, because at that point, all of her feelings were bad ones. Even when she looked at her soon-to-be-adopted child and felt love, the love just reminded her of how she came to feel that way, and she felt pain again. At times, I think the most therapeutic thing I can do for patients is to get them to accept some medication so they can have a respite from their pain. Sometimes, that’s the only way they can get some badly needed sleep. In the morning, they will have to start dealing with the pain all over again.
She accepted her prescription, thanked me again for my help and went home. I wondered what that must have been like for her, to go home and have to think about the life that was taken from her and how that which was left would always be such a strong reminder of what should have been. I thought about some of the things she had said that showed me she understood I was feeling a lot of guilt. She didn’t seem to blame me at all and I was glad because I couldn’t have taken much more of a beating than I was already giving myself. I was already loaded up on self-blame. There was no reason for it but it was there anyway because people in my job always wonder if we did everything he could have when things go so wrong.
Later that night, someone handed me the day’s newspaper.
“Hey, look at this story. Isn’t that the lady you saw a few weeks ago?”
Big headlines. LOCAL WOMAN MURDERED.
The story said that she had gone to the courthouse near the hospital to start the process of divorce. She did it a long way from her home so her husband wouldn’t know, just as I had told her to do. She had lived with this guy for more than ten years and had been beaten and abused by him for most of that time, still never fully realizing what a truly evil guy he was.
Somehow, he got a hold of a car she wouldn’t recognize and followed her to the courthouse, waited while she filed the papers and then continued following her when she left. Not too far from the courthouse he ran her of the road and shot her while several people watched in helpless horror. Then he got into her car and drove away, leaving her dying in the road. By the time the paramedics arrived it was too late.
I read that he had been caught on the way to the border and was headed for trial. In a way, it felt to me as if I was too. I know I did everything I was supposed to do. I followed the protocols and I remembered my training. I used my experience wisely but in the end it didn’t seem to matter and I keep wondering what else I could have done.
I don’t think the killer, sitting in a cell somewhere, separated from the other inmates who might want to beat him to death, is wondering if he did enough. He knows he did. Enough to ruin the lives of everyone who loved him, his wife, his son, even his dead wife’s best friend. I hated him for all that he did to those people and I hated him for what he did to me, to all of us who deal with tragedies like this one—people who, no matter how hard we try, will always wonder if we have done enough.