By Arnie Vainio MD
“I don’t have the friends I thought I had. My family doesn’t understand me. I was told I should only grieve for a year, but this was my son.” She’d been coming in to see me for almost a year before she volunteered that information. I should have asked her earlier and I thought I had, but maybe she wasn’t ready to talk about it.
I had seen her several times over the past year for chest pain and she had a very comprehensive evaluation and had seen a Cardiologist twice. She had a stress test initially, then finally an angiogram. This is the gold standard for testing for heart disease and involves a catheter inserted into an artery in the groin and advanced to the blood vessels that supply the heart itself. Contrast is injected into the coronary arteries and if there are any blocked arteries, they will show up on the monitor. There was nothing wrong with her heart.
“Do you want to talk about it?”
“It’s all I want to talk about. No one wants to listen.”
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“OK. Andrew died eight years ago and I think about him every morning when I wake up and every night when I’m falling asleep. He was only nine years old and he shouldn’t have been playing by the river. He knew better than that, but there was a neighbor boy who liked throwing rocks in the water. They were on a steep bank and Andrew slid into the river and it was too slippery to climb back out. It was the next day before they found his body a half-mile downstream.
Do you know what it’s like after the funeral to have everyone pretend life goes on as usual? How can anything be normal or usual? My husband buried himself in his work and our marriage lasted for two more years. My friends didn’t want to talk about it and their invitations to lunch and their phone calls were less and less and finally they stopped altogether.
I had people tell me, ‘At least you have two other children.’
I know I have my other children, but that doesn’t make losing Andrew any easier or different. He died in the fall and that first Thanksgiving and that first Christmas were the hardest, but all holidays are hard. This is the year he would have graduated and I think about what he would be like at this age and what his plans would be for after high school. He liked sports and I always wonder if he would have been an athlete. The people around me don’t want to say his name, I think because they’re afraid it will remind me of him, but everything reminds me of him. Saying his name would at least let me know I wasn’t the only one thinking about him.
I turned to alcohol for a while after my husband left and maybe even for a little while before. I thought it would make me forget, but it made me remember even more. One morning I woke up on the floor with my five-year-old daughter sitting cross-legged next to me and scolding her doll for having her life so easy. A week later I lost my driver’s license for driving while intoxicated and I had to go to treatment.
I was angry with my husband for leaving and angry with him for not grieving like I was. I was angry with my daughter and my other son for laughing and playing at Andrew’s funeral, but they were only four and seven at the time.
My mother-in-law told me, ‘It was God’s will.’
How is that possible? I lost faith for the longest time and I still don’t know if I have it back. How could it possibly be right to take a nine-year-old when there are people who don’t value their own lives? How can a nine-year-old die when there’s somebody somewhere right now shooting heroin?”
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My pager went off for my next patient and she apologized for taking so much time and asked if she could reschedule. I ended up seeing her often for visits for her blood pressure and for general health visits. I remembered what she said about others remembering and most times I was the one who mentioned Andrew first. She scheduled a visit with me on his birthday and she cried through most of the visit.
It was a couple visits later when she stated maybe her husband burying himself in his work was his way of grieving and she felt bad for holding that against him and that maybe things could have been different.
My time in Seattle was drawing to an end as I was finishing my residency and I sent a letter to all my patients letting them know I was leaving to go back to Minnesota. She was one I really feared would see me as abandoning her and I walked into the room with some trepidation.
We talked about her blood pressure and reviewed her home blood pressure readings. They were finally under control. She had not had any chest pains since that first visit she talked about Andrew. I asked her if she got my letter and she said she did. I asked her if she was going to be all right.
“At first, I didn’t know if I was. I will always hurt and nothing will ever change that. It had been so long since anyone would let me talk about Andrew without giving me advice or empty promises. You simply listened to me and I appreciate that more than you will ever know.”
She handed me a box wrapped with a red ribbon and told me I could open it later. Later in the day I got a chance. Inside were a dozen cookies and a note:
“I am a mother and I will always be a mother. I still have three children and one of them would have graduated last year. I love them all and one loved my oatmeal raisin cookies. I haven’t had a chance to make them for him for a long, long time. Please remember him for me. Thank you.”
Arne Vainio, M.D. (Mille Lacs Band of Ojibwe) is a family practice physician on the Fond du Lac reservation in Cloquet, MN. Email: firstname.lastname@example.org.