Tuesday, January 8, 2013

Funeral Homes

I'm always a little anxious during the drive to a funeral home to pay my final respects to a patient.

Last week, I took my first such trip since moving here, and the nerves returned. A paranoid voice inside me wondered, again, if someone at the viewing would blame me for their loved one's death.

Admittedly, this has never happened.  Family members are invariably appreciative of these visits, and I am often introduced proudly to multiple family members as "So-and-so's doctor." These new acquaintances then usually shake my hand or even hug me.  They sometimes express surprise that I am there (which makes me a little sad, since I was taught that attending patient viewings and/or funerals is a natural duty of the family physician and an important opportunity to say goodbye).

When a patient of mine dies unexpectedly, I usually comb through the chart, looking for any mistake I might have made.  It's a ridiculous compulsion based on the impossible idea that I am omnipotent enough to foresee every possible problem that might happen to my patients.  I'm not omnipotent, of course.  And, no matter how good of a doctor I am, all of my patients will eventually die of something.

But I always wonder - did I miss something?  And, I figure, if I'm wondering that, maybe my colleagues are. Or my patient's surviving family.

Overall, I consider myself reasonably comfortable with the end of life as a family doc.  I am disheartened when patients and/or families insist upon invasive, aggressive care that I know to be futile.  I've talked about hospice and end of life wishes with patients and families numerous times.  But, maybe, obsessively sifting through charts and worrying over what others think of me reveals that I'm not really that comfortable with death.  I am, frankly, ashamed of the hubris I must possess to assume that the end of a patient's life has much of anything to do with me at all.

Maybe that discomfort's not so bad, then; it certainly reminds me that I am only human myself.

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