There is nothing on earth that could make this conversation better—but there are things an inexperienced doctor can say that would make it infinitely worse.
I walk in the room where a petite, light-haired woman sits in a chair in the corner. When I was young and green, I would’ve wondered why she’s here by herself. If she has a husband or other children . . . or if her son was her entire world.
I know better than to think about those things now.
“Ms. Allen?”
Her face lifts expectantly.
“Yes?”
I move forward, stopping two feet from her chair—within reaching distance.
“I’m Dr. Connor Daniels. I’m the physician who treated your son, Brandon, when he was brought in after his car accident.”
“How is he?” she asks. “Can I see him?”
I look into her eyes and make it quick, even though that won’t make it easier to hear.
“Ms. Allen, Brandon was critically injured when he was brought in—his heart was not beating. We gave him medicine and blood transfusions and used every tool and technique available, but I’m sorry to have to tell you that his injuries were too severe . . . and Brandon died.”
It’s important to use the actual words. Dead, died. It’s brutal, but euphemisms breed hope and there is no room for hope here.
She blinks. They all blink at this part—in that short, hazy window of time before the words sink in and make sense—and their lives are forever changed.
“But . . . I just saw him. I talked to him. He was fine.”
“I know.”
She shakes her head.
“He was going to the store. He’s on a new weightlifting diet and I forgot to pick up chop meat this afternoon.”
“I understand,” I tell her. “I’m so sorry.”
“Wait. Are you—”
She tries to stand, but her knees give out. I catch her before she goes down, holding her up.
“Easy . . .”
Her fingers twist in my coat and she wheezes for breath, like I’ve kicked all the air out of her lungs. She lowers her head and tries to scream but she can’t—only a strangled, suffocating gasp comes out.
When you do this long enough and the years go by, you forget the names. But you never forget their faces. The sounds they make when you tell them. Jagged, incomprehensible sounds filled with horror and grief.
If hell exists . . . I think this is what it sounds like.
I guide her back into the chair but she holds onto me, her eyes desperate and darting.
“Are you sure it’s my Brandon? Are you sure he’s really . . . that he died?”
I don’t look away; I meet her gaze directly—because she needs this.
“Yes, I’m sure it’s Brandon. He died. I’m deeply sorry.”
Her hands fall away and the life goes out of her. She stares, unseeing, at the floor and she won’t hear anything I say now, but I tell her anyway.
“This is Chaplain Bill. He’s going to stay with you, and help you with the next steps.”
She doesn’t answer; she doesn’t blink. Not anymore.
I turn and walk out the door. I don’t stop walking until I’m around the corner at the end of the hallway—reminding myself to breathe.
At my elbow, the resident is on the verge of losing it—her cheeks red, her eyes full.
“Do not fucking cry,” I order, sharp and mean. To snap her back—make her refocus. “Not here, not now.”
She sucks in a shuddering breath, trying.
“I’ve never . . . that was the first time I—”
“Okay.” I nod, guiding her to lean over slightly. “Bend your knees and breathe. Three deep, long breaths. Come on.”
She inhales, slow and shuddering, eyes closed. Then she does it again, shaking her head.
“That poor woman.”
“Don’t think about it.”
“How do I not?” she rasps.
“Picture . . . a safe in your mind. Thick, steel walls and one of those huge locks like the vault at a bank. And you take Ms. Allen and everything you’re feeling and you put it in there—and you shut the door, lock it up. Because we have three other patients waiting. Maybe three other Brandons that you can still help, three more chances to not have that horrific conversation. But you can’t treat them if you fall apart. If you’re distracted and upset and your vision is blurred.”
She nods, inhaling slowly again.
“When you’re home, later,” I tell her. “When you’re in the shower or in bed—that’s when you open the safe. Let yourself feel it—you won’t want to but you need to. Because this job isn’t about saving everyone—if you go in with that as your expectation, your career in emergency medicine is going to be epically short. The job is to keep going . . . knowing you can’t save everyone.”
She stands straighter now, head lifted, breathing steady and eyes clear.
“Okay.”
“You good?” I ask, just to be sure.
“I’m good.”
I take the chart from the wall outside the exam room door.