Helping survivors cope with their sorrow

Commentary. By Eric Anderson, MD, AMNews contributor. Jan. 26, 2004.

COMMENTARY

Observations on the state of medical practice and medical life

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There are patients right now in our waiting rooms whose needs may never be met. Those concerns won't be addressed because they aren't the reason for the visit as documented by the receptionist or nurse.

The unmentioned problems hovering over our patients might include the intractable difficulty of a son who refuses treatment for his schizophrenia or a granddaughter who denies her drug addiction, or could embrace the angst of a woman who is having an office affair with a married man or the ache of a husband who has just lost his wife.

Of all those concerns not broached, one of the worst must be the pain of sorrow.

Margaret, my wife, kept a magnet on our refrigerator door for years. It was still there when she dropped dead in our kitchen. It read, "Every cloud doesn't mean a storm." Such innocence! Such little knowledge of the skies above us. Because for many of us, especially if the marriage was a happy one, the death of a loved one is a storm enough to top Shakespeare's The Tempest. It may last the survivor's lifetime. And the sting of such sorrow can be almost insufferable.

Little Finland, oddly enough, is the one country that keeps immaculate data on deaths. Its statistics show the death rate for the surviving spouse increases 600% six days after the death of the first spouse. Finland's health workers believe the sixth day is, conventionally, when relatives go home and the survivors are left to themselves. To grieve alone.

Patients who are grieving may come to their doctor on many pretexts: blood pressure checks, lipid assessments, flu shots. If the booking was for a brief office visit, doctors don't want to dig too deep -- we can't afford to. Time is money. But perhaps, even briefly, we could help our patients cope better when they've had a huge loss if we better understood what's happening to them.