Perspective
Going Gracefully
Lessons learned well before they are needed are put to use when we face a loved one’s death.
By Janis Amatuzio, M.D.
In August, my father died. As I write these words, the grief is still fresh in my heart. His death was sudden but not unexpected. At 88, my father, an internist, had diagnosed and managed his own renal disease (serum creatinine 5.4; BUN 65) by diet and force of will. When symptoms and age overwhelmed him, he deliberately chose hospice care in order to die at home, in his own bed, with his loved ones by his side.
It was a moment I dreaded for years, the death of my father—the gentle man who took me on house calls when I was little, helped me dissect math problems in high school, and surprisingly encouraged me to pursue pathology when I initially chose internal medicine.
My father and I had talked about death after I made my very first house call with him. I was 9 and remember his reassuring words as we walked home from visiting our neighbor, Mr. Phillips, who was dying of end-stage Parkinson’s disease.
He gently said to me, “What do you think happens when we die?”
“I don’t know, Dad,” I answered.
“We go to heaven. We go to be with God.”
“Where is heaven, Dad?” He took a deep breath, paused, and said, “Well you have to close your eyes and imagine the happiest, grandest, best place you can, where all the special people and animals in your life are gathered, where the sky is velvet blue and the flowers smile, and you feel like you are finally home … and that, Janis, will be heaven.”
My father said those words with the confident tone of a man making a diagnosis, and they have reassured me always. But they did not prepare me for the waves of grief that naturally followed his death.
Elisabeth Kubler-Ross wrote that grief honors our love, and that if we choose to love, we must have the courage to grieve. I realize now that studying death, grief, coping, and loss really does help. Knowledge about this most painful subject has provided me some grace. If wisdom is knowledge applied, perhaps then grace is the intuitive nudge that causes us to use what we know. I began to seriously study grief and loss when, as a forensic pathologist, I began talking with and listening to the families of deceased persons who received my care. I made it a practice to call family members and explain the autopsy results in noncriminal cases, to send a letter, and, when needed, to meet with them in person.
These meetings were not easy for me, as grief has many faces including anger and despair. At first, I almost stopped making those phone calls; the pain was too intense, the grief too palpable. But then, when I faced those families’ grief, I realized I faced my own as well. I began to learn from the loved ones of those I had cared for as they shared stories that at times filled me with wonder.
I attended conferences, studied, and eventually began to lecture on life and death. At one seminar, I heard a parable about a student and a monk. The essence of the story is this: A student came to his teacher with the alarming news that his own father had been suddenly diagnosed with a life-ending illness and was about to die. The student asked the monk what he should do. The monk immediately answered, “You must go to his side, be with him and your family, and grieve over this terrible tragedy.” The student did as he was told, and grieved and wept for days until he could cry no more.
He went back to his teacher and poured out his heart. “Is there anything else, Master?” he asked. The monk nodded thoughtfully and said, “Yes there is, give him permission to die, permission to leave. Tell him it is all right with you, and mean it.” The student swallowed hard, nodded, and rushed back to his father’s side to give him permission to die.
The father persisted. The student went back to his teacher and sat at his feet. “I have done your bidding, Master. I have followed your instructions. My father can die now in his own time.” Then the monk said quietly, “You have done well; you have grieved and you have let go. But there is one more thing you must do, and this one will be the hardest. It will require you to grow up.”
“What else could there be, Master?”
“You must go to his side, take his hand, and look deeply into his eyes. Then you must tell him you will be fine, you will be well, and will live fully because of his love and example.
“But I’m not fine!” the student protested. “I’m sad and angry and unhappy. I don’t want him to die.”
“Be all of those things,” the monk said. “You must cry and weep and mourn until your heart heals. But give your father the gift of assurance, assurance that he has given you everything you will ever need to love fully and live well. Then he will go in peace, his heart will be full. For that is the nature of a father’s love.”
I remembered that parable during the intimate days just before my father’s death. It was a special time when he talked about his wishes, planned his funeral, and reflected on his decisions and desires. I knew it was the time to gently listen, to let go, and to witness the beautiful inner and outer transformation as he prepared to “go home.”
Several days before his death, I was able to say those difficult words to him, “I will miss you,” “You can go,” and “I will be fine.”
He looked over at me as we sat in the kitchen together. A smile spread across his face, and he said, “Thank you, Jan. I am a free man now; and remember, I’ll always love you.”
I am convinced that knowledge is one of the keys to meaningful living; and perhaps when we apply it gracefully, wisdom emerges. MM
Janis Amatuzio is a forensic pathologist and the medical examiner for several Minnesota counties. She is also the author of Forever Ours: A Forensic Pathologist’s Perspective on Immortality and Living and Beyond Knowing: Mysteries and Messages of Death and Life.