“How do you do this?”

We had just spent the better of two hours with a newly diagnosed cancer patient.

A patient young, certainly by the standard of my own 60 years.

She herself still absorbing the news that she, no one, ever hopes to hear. Her husband, at more remove, fathoming, all at once, the unfathomable. The visit itself emotional, more so than any of us in that room might ever have expected.

With me, this visit, one of the Family Medicine residents with whom I work as faculty. She, the entire time, quiet, but attentive, paged once from the room—and long then in returning.

It was one of those patient visits when I do what I usually do; when Melanie, the palliative medicine nurse accompanying me this day, most days, does what she usually does on any day; when neither Melanie nor I thought we were anywhere outside the territory we usually inhabit, despite the patient’s relative youth, despite the poignancy of the moment.

But for the resident—new to this and young herself, perhaps new to death, and certainly to this, to death’s insistent rap at the door—heartrending.

“How do you do this?” she asks me, seconds after leaving the room, her voice rising on that last word, the two of us praying foam into our hands, the better to deaden exposures more benign than those to the heart, even as we put backs to the room, even as we turned to the corridor.

“I twice wanted to get up and leave, was glad for that page,” she says.

And again, seconds later, “How do you do this?”

“I don’t know,” I replied, that much the truth, pausing a few seconds. “Someone has to,” I say feebly. “Maybe me.”

The thing is, until that resident asked me that question, I had not ever asked myself how I do this.

I just do it.

Sure, there are nights when I come home from a day on palliative all but empty emotionally.

The whole day death, dying.

And me, in the evening, just home from work, in a chair, in the living room, quiet, my wife Karen respecting that silence, maybe an hour, maybe a little more, me the whole time awaiting the tide: for life to flow again, for death to ebb again, at least for today, for now, for the moment, this moment.

So, how do I do this?

Nothing in med school, not one hour of pathology, not an entire semester of pharmacology, no amount of biochemistry, no one or any combination of rotations, could ever have schooled me to do what I now do.

Even I, now faculty at a Family Medicine residency, adjunct faculty at the nearby medical school, am unsure how to teach what I’m not sure can be taught, except by me letting that resident, any resident, just experience this: life, life itself; death, the awful imminence of death.

But how to instill in those residents, those med students who follow me, my own long life before I began med school at age 49. My own losses along the way. The things that make me who I am, that taught me.

My mother’s death, herself, her beautiful self, then just 49, to breast cancer. My father’s to pancreatic cancer at 66—and him, a good man, a good father, looking to life ahead, but dead almost before he knew he was dying, before he could make amends for things no one of his five children thought needed amending.

And before that…

An uncle, my father’s kid brother, dead to fire at 28, only two weeks after the death of my own mother’s mother. Just two years later, my father’s only, other brother, dead himself, at 26, in a car accident. And, in the year between, a miscarriage, it just shy of taking my own mother’s life, she a breath from death that day at arrival at the hospital.

And me coming home from school that afternoon, blood spotting, no murdering, the path our family doctor had walked from mattress to front door; he, seeing what he had seen, scooping my mother in his arms, carrying her to his car; the oar of the steering wheel then in his hands; and he, suddenly Charon, ferrying my mother to the hospital. And my father, later that night, his eyes hollow, the near loss of his loved bride beyond any attempt to be anything less than just that, lost.

And me, all this time, only a boy, oldest then of four, but, oldest or not, a boy.

And later still, a friend, my age then, my age then young, dead by his own hand at 29. An uncle, himself later a suicide. All aunts but one, all uncles but one, now lost to all but memory.

How do I do this?

I learned only from life.

My hand, only days ago, on a patient’s hand. She, only weeks ago turned 50, new to the news that she had incurable lung cancer. Her eyes, lids pooling tears, on mine.

“I’m scared,” she says, her voice failing.

“I know,” my hand tightens on hers, hers tightening on mine.

And, just behind me, her three daughters, all of them young, all three thinking, as all of us always do, that they would have their mother, their loved mother, forever.

And just minutes before, my own arm around the shoulders of one daughter, and me telling her, “I’ve been here. I do understand.”

But, God, how I myself so often hurt, still often cry.


© 2011, Dónal Kevin Gordon

Once in September…

Until that day, that day was our son Brendan’s birthday. Always, always a happy day. A day, in our home, to celebrate life. Our own Brendan’s life.

But that was before September 11^th became 9.11. Before Brendan’s birthday became a remembrance of things past, that past all at once lit against sudden darkness. Before Afghanistan. Before Iraq. Before Homeland Security and pre-flight pat-downs. Before any of us thought any of us had anything to fear.

And now…

The pages of history dog-eared by columns burning. By pictures of the lost, taped and thumbtacked, sunlit by day in that last summer, by night by candle. By hope, tears, anger, memory, grief, revenge and, for some, an uncentered joy.

And Brendan himself, today 27, a decade after a teenager’s birthday was hijacked and made his generation’s Pearl Harbor?

Four years in New Orleans, helping to rebuild after Katrina.

Two stints in Haiti after the earthquake.

And just yesterday home from Japan, after months doing his part to undo a tsunami.

A life, so far, well lived.

But all those other lives lost.

Those many thousands of lives, these many thousands of days later.

The good those lives, left to live, might have done. The love they would have shared. Those other hearts, those hearts the lost themselves once loved, not ever broken.

And today?

Today we remember things past, even as we imagine that future all those lost would have all of us imagine.

And here at home, here in this small town in Iowa, here at this old yellow house that has already seen its share of history, watched so many lives quietly come, quietly go. A house that has heard laughter dampened by time. The laughter of children who lived their lives, only in time to themselves become ghosts. An old yellow house that remembers, in its way, all those who passed this way.

Here at this old house, we today celebrate life. Celebrate Brendan. The good he’s done. The joy he’s given. The hope he, at 27, represents for us. For all of us.

© 2011, Dónal Kevin Gordon

Oh, to prey in Pray…

“Come on in! Have some fun!”

That invitation—coming from one of four guys pumped on something stronger than sun, all four doing their own kind of homeland security, all of them posted outside a bar in this, the middle of a weekday afternoon, here in the middle of sky-big, sun-amped Montana—was, not surprisingly, not at all a pass, lateral or otherwise, in my direction.

Not when the first of us to cross any one of those eight, paired guy-eyes was my attractive, my looking-decidedly-younger-than-her-years wife, and our own equally attractive, calendar-younger daughter. With me lagging enough behind. Just enough so to make both lasses look like they’d not ever be with a guy so grey above the ears as me. Not by choice, certainly. Not by any stretch of any guy’s imagination. Let alone the beer-and-a-bump imaginations of these particular guys.

“Come on in!” one bleats, beating his buddies to their own blurts. “Have some fun!”

Those guys, those four, all four steadied by the four legs of their chairs, those chairs outside a bar, mid-afternoon, all of us, this very mid-afternoon, somewhere south of Pray, in southern Montana. All four guys, at the least, the bar’s own welcome committee; at best, the town’s chamber of commerce; at worst, just four guys hoping, hoping for their own, anyone’s, version of the best.

Me, remembering a younger me, can’t blame them, though, for trying.

“Come on in! Have some fun!”

A come-hither, at once consummate, consummation itself still anyone’s guess.

Meanwhile, this hither worth the hither, brew-breathed or otherwise.

Y’miss most, y’get lucky once, y’go to bed counting the day good, they gotta be thinking.

And, always, always, the prospect of another come-hither, lucky, if luck revisits, and another, at the end of the day, good day.

So, yeah, why not. “Come on in! Have some fun!”

© 2011, Dónal Kevin Gordon