Maybe You Should Talk to Someon - Lori Gottlieb Page 0,171

This doesn’t apply to other professionals in the person’s life: Julie’s attorney, chiropractor, oncologist. Nobody blinks if they attend the funeral. Therapists, though, are expected to keep their distance. But what if their being there would comfort their patients’ families? And what if it would comfort the therapists themselves?

Most of the time, therapists grieve their patients’ deaths in private. Who could I talk to about Julie’s death other than my colleagues in my consultation group or Wendell? And even then, none of them knew her the way I did or the way her family and friends (who get to grieve together) did. The therapist is left to grieve alone.

Even at the funeral, there are confidentiality issues to consider. Our duty to protect our patients’ confidentiality doesn’t end with death. A wife whose husband has committed suicide, for instance, may call up her husband’s therapist to get some answers, but therapists can’t breach that code. Those files, those interactions, are protected. Similarly, if I attend a patient’s funeral and somebody asks how I knew the deceased, I can’t say I was the therapist. These issues come up more in unexpected deaths—suicide, overdose, heart attack, car accident—than in situations like Julie’s. After all, as therapists, we discuss things with patients—and Julie and I had discussed her wish that I attend the funeral.

“You promised you’d stay with me to the end,” she’d said with a sideways grin about a month before she died. “You can’t abandon me at my own funeral, can you?”

In Julie’s last weeks, we talked about how she wanted to say goodbye to her family and friends. What do you want to leave with them? What do you want them to leave you with?

I wasn’t talking about transformative deathbed conversations—those are mostly fantasies. People may seek peace and clarity, understanding and healing, but deathbeds themselves are often a stew of drugs, fear, confusion, weakness. That’s why it’s especially important to be the people we want to be now, to become more open and expansive while we’re able. A lot will be left dangling if we wait too long. I remember a patient who, after years of indecisiveness, finally reached out to his biological father who had been seeking a relationship, only to be devastated to learn that he was lying unconscious, in a coma, and would die within a week.

We also place undue pressure on those last moments, allowing them to supersede whatever came before. I had a patient whose wife collapsed and died in midconversation, as he was being defensive about not doing his share of the laundry. “She died mad at me, thinking I was a schmuck,” he said. In fact, they’d had a strong marriage and loved each other deeply. But because this one argument became enshrined as the final words they exchanged, it took on a significance that it wouldn’t otherwise have had.

Near the end, Julie fell asleep more often during our sessions, and if before it seemed like time stopped whenever she came to see me, now it felt like a dress rehearsal for her death; she was “trying on” what it would feel like in the stillness without the terror she had of being alone.

“Almost is always the hardest, isn’t it?” she said one afternoon. “Almost getting something. Almost having a baby. Almost getting a clean scan. Almost not having cancer anymore.” I thought about how many people avoid trying for things they really want in life because it’s more painful to get close to the goal but not achieve it than not to have taken the chance in the first place.

During those luxuriously quiet sessions, Julie said that she wanted to die at home, and for our last few sessions, that’s where I saw her. She had surrounded her bed with photos of everyone she loved, and she played Scrabble and watched The Bachelor reruns and listened to her favorite music and received visitors.

Finally, though, even enjoying those pleasures became difficult. Julie told her family, “I want to live, but I don’t want to live like this,” and they understood this to mean that she would stop eating. She was no longer able to eat most foods anyway. When she decided the life she had left wasn’t enough of a life to sustain, her body naturally followed suit, and she was gone within days.

We didn’t have a profound “grand finale,” as Julie had been calling our final session. Her last words to me were about steak. “God, what I would give for a