The Dying Tradition of the Doctor’s Condolence Letter

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By Suzanne Leigh

In a medical journal article, a doctor writes candidly and bravely of a painful conversation with a widow that marked a climacteric point in his role as a health care provider. After the woman’s husband had died of metastatic lung cancer following nine months of treatment, his physician had failed to reach out to her.

The writer, Dr. Gregory Kane, a pulmonologist at Jefferson Medical College in Philadelphia, says he was considering telling her that the physician may not have been on call and had mistakenly assumed that his partner had conveyed his sympathies, when the crying woman said something unforgettable: Even her veterinarian had sent a card when the family dog had died.

“I was speechless,” writes Kane in his article for the journal CHEST.

The reluctance of doctors to contact the bereaved reflects a number of factors, says Dr. Ishani Ganguli, a blogger and resident in internal medicine/primary care at Massachusetts General Hospital. “We may not know the patients as well or for as long as we used to: hospital stays are now measured in days instead of weeks. Working in teams, we often shift which doctor has primary responsibility for a given patient, so niceties like letter-writing are more likely to get lost in the shuffle.”

Ganguli makes good points. I’d like to add another one, which doesn’t relate specifically to doctors: Our society doesn’t do death very well these days. As the anthropologist Margaret Mead observed, “Mourning has become unfashionable. The bereaved are supposed to pull themselves together as quickly as possible and to reweave the torn fabric of life.”

In his article, Kane urges his colleagues to revive the “dying art” of the doctor’s condolence letter. He proposes this formula: acknowledge the loss, recall a special memory of the deceased, note the loving qualities of the survivors and make a genuine offer to be available to them. I think these are great recommendations, not only for doctors but for everyone who wants to express their sympathies. I like the “special memory” part most of all.

Don’t worry about not having a medical license to write a condolence letter — or even a high school diploma. This is one of my favorite letters written by Natasha’s classmate, a 12-year-old boy. His account of two brief interactions with Natasha is astonishing: it’s outwardly unremarkable and inwardly insightful and poignant to those who love her. I’ll always treasure it.

Dear Mr. and Mrs. X and Marissa,
I am very sorry for your loss. Natasha was a very nice girl. Natasha was always happy and NEVER EVER negative. Even though Natasha was tired she tried to be happy. Natasha was so brave and dedicated to school!
I remember one time in Miss X’s class. She was looking for an assignment and dropped a pen. Then when I picked it up and gave it to her she smiled at me and it made me happy because her smile was so nice and generous. It also made me happy that all I did was pick up her pencil.
Another time I remember is when I saw her at the pizza restaurant. I was going in and all of you were leaving and she gave me the exact same smile. It made me very happy. Any time Natasha smiled at me my day brightened up.
Sincerely,
Natasha’s classmate

Natmarteeth
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