By Robert Lanz, LCSW
Of course I cried.
I cried when a young man told me how sad he was caring for his dying mother. My own mother had recently died at ninety after living a long and healthy life, but the pain was still fresh. The doctor who sent me in to talk to the young man knew that my mother had just died and he knew the effect the intervention would have on me. There is no mercy for these things in the ER, nor should there be. We are there to take care of people. Them first. Us later. That’s it. In this case, my feelings weren’t the issue, the other guy’s were. If his feelings caused me pain, that was an issue for a later time.
Sometimes, the docs have to try to save the life of a child when they have a child the same age at home. Sometimes that kid they’re trying to save dies. Does the doc get to cry? Not in public, and neither do I. Do we puddle up a little? Of course we do. My job involves being in the middle of pain—the pain of death, of loss, pain caused by the fear of life changing events. I take the job seriously. These aren’t books or studies or diagrams, they are people in pain, and I’m in it with them.
It’s not wrong for people to see me get teary-eyed. I always told my grad students, “Look, if you start to get teary-eyed, that’s OK, you’re human. But if you start weeping, leave the room and come back when you have more control. Apologize if you think it will help. This pain is their pain and you don’t get the luxury of letting yours out. You’re there to help patients and families and friends with their pain. If you show too much of yours, one of those people will start feeling the need to comfort you. Sometimes that’s OK. It may make them feel a little better, but mostly, I discourage it.”
Once, when I first started out in the ER, I sat in the quiet room with an elderly woman while her husband was in the cardiac room dying, about fifty feet away. His name was Walter and he was a plumber. Nothing we did was going to bring him back to life. His heart gave out, but it gave out slowly, dying in small increments for about an hour. During that time, I stayed with the wife while the medical staff did CPR, multiple defibrillator shocks, and several rounds of IV medications along with all those other things on the desperation trail that ends in death most of the time. In the hour it took Walter to finally die, I went back and forth between the cardiac room and the quiet room with ever increasing bad news. When Walter’s flat line was obvious and the code was finally called, the doctor and I returned to the quiet room together. Walter’s widow wasn’t surprised by the news.
Sometimes in these situations, the families cry. Sometimes they curse, sometimes they fall to the ground and flail around. I’ve had people throw punches, throw chairs, blame us, blame God, even start trash cans on fire. Sometimes they tell stories. You never know. Walter’s widow was sweet, and reminded me of my grandmother. She told stories about Walter and wept a little, then she showed me pictures of their honeymoon in Hawaii. She was wearing a beautiful red plumeria lei and Walter was sporting the coolest Hawaiian shirt ever.
It could have been my parents in that picture. Or it could have been me, had I been born in an earlier time. I could see that Walter was my kind of guy. In my coming and going during the time of Walter’s dying, I learned a lot about him and about how he lived his life. I learned so much, in fact, that when he died, I did puddle up a little because by then I felt I knew him, and I knew that he had one of the greatest wives ever. She looked at me and saw my tears well up. She reached over and gave me a little hug and said, “It’s OK Bob, he had a good life.”
Did I ever cry? Hell yes, and I’m proud of it.