Reflections on the grief of losing a patient

I lit a candle for you today.   

Your passing, while I knew it was inevitable, completely caught me off guard. It came so quickly, I didn't have time to prepare myself. Although I'm learning I never really can prepare myself for these kinds of things.  If only I would have known the last time I saw you would be the last time I saw you. I would have spent more of our time together looking at you to see you, not looking at you to assess you as my patient.

Even so, the last time I saw you is imprinted on my mind. Somehow that day you had a different kind of look in your eye. Almost like you knew a truth the rest of us could not yet see. You stood in my office doorway, your skirt flowing as you gently swayed and reached up to adjust your wig. The beautiful long wig that was covering your baldness, keeping your head warm until your own hair could have a chance to grow back. Your hair was one of the many things the chemotherapy had taken from you. But it could never take your beauty.

As I reflect on that day, I realize there had been something different about you. I thought it was because you were feeling better. Maybe you had a new kind of peace about you -- I'll never know. But I saw a new kind of spark. Like life force itself was renewing inside of you and creating a different kind of beauty emanating from your being. But quite honestly, I think I'd just opened up my eyes to see your beauty in a new way. You had always been a beautiful person, but maybe a part of me knew somehow it would be my last chance to see you shining.

I lit a candle for you today.

Because when I got a one-line email from an administrative assistant a few days later telling me you had passed, grief took over my body. It looked like pale skin. It felt like clammy hands, racing heart, and a gut-wrenching pain in my chest. It sounded like me slamming down my grief into the back of my throat because I felt like I had to drown it. I tried to swallow it, but my grief for you would not be ignored. I had to make it go away, so that I could keep doing my job. I had other patients to take care of. The operating room was prepped and I had to scrub in. I told myself I had to be "strong," calloused, even, so that I wouldn't upset my other patients. So that I could be presentable. So that I could take care of the other women waiting for me. Even though I needed time to process and let my emotion flow through me, there was no time to grieve.

And yet my grief would not have it.

I lit a candle for you today.

Because even though I got through the next few hours with my grief stuck in my throat, I was barely holding on to it. I walked back to the clinic counting on being able to let down. I walked through the doors and found that everyone was busy going about their day. Maybe they swallowed their grief, too. Or maybe theirs was waiting at the bottom of a whiskey glass once they got home. Maybe their grief was baked into their dinner that night, or reflected back at them from the television screen before bed. Maybe they had felt so much grief over the years they wouldn't, couldn't let any more in.

I suddenly felt very alone. I wanted to grieve for you with someone. I reached out for support from my colleagues, but everyone else seemed to be turned inward. It made me feel like I needed to turn inward, too. Maybe my initial reaction to shove the grief down my throat was what was expected of me as a medical professional. Maybe turning inward was the way everyone in my profession dealt with the unfathomable losses we witness on a regular basis.

I started to wonder if I was being too sensitive. If the tears in my eyes I was fighting back were a sign of a person who cared too much in all the wrong ways.

I lit a candle for you today.

Because honestly, I don't want to turn away from this reality of your passing. I don't want to bury my grief. If I try to, it will make itself known in other ways. And I'd rather name it for what it is. Rightly so, it stands up taller and louder until I call it by its name.

Grief, I see you.

Grief, I feel you.

I am learning to stay open even when it hurts. Because that is the only way I'll ever truly be able to see you, my patient, for who you are. And I want to see you. Staying open to my experience is also the only way I'll ever truly be able to see myself. I want to see me, too.

I also want to honor you and the life you had. I want to name the gifts you gave me. I want to say thank you. I want you to know that your life mattered. And so does your death.

I want you to know it was such an honor to care for you during your last few months.

With all the vital signs, chemotherapy, hospital admissions, and scans, my favorite part of caring for you were the small moments when I got to see who you were. Like the way you loved to read old romance novels.  You told me that reading them provided you with an outlet, a fantasy with a happy ending, different from the reality you were living -- and the imminent outcome we both knew was coming for you.

I lit a candle for you today.

Because it is my ritual to honor you. To ignite the fire, to watch it burn and to think of how your light brought gifts into the world. To stare at the flame as I wonder what was most important to you and how you'd like to be remembered. Somehow I wish I would have had started those conversations.

I lit a candle for me today.

So I could stare at the flame , and channel my grief into it. So something could catch and hold my pain. So I don't have to swallow it but instead can have something to point to that says “There, there is the grief.” See how it throws shadows on the wall? See how it flickers and plays with the light? See how it burns hot and intense but doesn't burn the house down?

I lit a candle for us today.

So I could honor the time we had together. So I could call out to you, a signal to wherever you are to tell you that you mattered to me. That your life was not disposable. You weren’t just another number, another sick patient. You were beauty. You were strength. We were connected by our common humanity, and just like the flame of this candle dances with the air around it, we danced, too.

I let a candle burn itself out today.

So that I could let you go. Because I know wherever you are, you are safe.  And cancer is no longer connected to you. As the flame slowly fades out, I feel it move into my chest.

I breathe in the stillness that resides in the space between flame and smoke.

Our time together, as patient and health care provider, will live there.

I honor you.

I honor me.

My grief is a gift that lets me see these truths: 

My grief matters.

Your life mattered.

Your death matters.

You matter.

With Love,

Niki