C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

A Mother’s Death

Takeaway

Including a patient’s words in your empathic response is affirming and creates connection.

“This shoulder is painful right here in the scapular region. The borders of tenderness are clearly felt, you can demarcate it with palpation.” The young oncology nurse who led the chemotherapy infusion center was now on the other side of the infusion. I followed her instructions to examine her shoulder as she directed me to do so. 

 

“What are you most worried about?” I asked.  

 

“I don’t want my sons to see me in pain. I don’t want them to remember their mother in pain. I don’t want my pain to make me less of a mother. I want time. I want more time,” she sobbed. 

 

I’d demarcated the borders of her tenderness by now and sat and held her hand as she cried. Her sister held her other hand. 

 

“These are dangerous scary places to go to alone doctor. I’m glad you’re here with me,” the patient said. 

 

“I’m here,” I said. “I want more time for you, too.” 

 

These moments of connection, holding the space for the patient to openly share her existential awareness of mortality, opened the gates of her planning and legacy work for her two pre-teen boys. She realized that in fact, she did have a little time. Time to prepare for her own death. To say things unsaid to her sister, children, and husband. The next day, she decided to record videos for her sons to watch at future milestone events and write letters for them filled with wisdom from her lived experience. She also left instructions for her sister, husband, and friends.  

 

When I’d sat with her, I’d held deep compassion for her sorrow and for her fear of being less of a mother. I grounded and centered myself in my awareness and immersed myself in the moment. I tried to offer a therapeutic and compassionate presence, attuned to the patient’s experience. I too wanted more time for my patient, for her to see the time that was already there for her.  

 

Empathically repeating a patient’s words back to them is one way to validate a patient’s experience and create connection.  

 

“I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.”—Maya Angelou

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.