Author Affiliations: Division of General Internal Medicine and Geriatrics, Palliative and Supportive Care Program, Medical University of South Carolina, Charleston, and Beacon Hospice, Mount Pleasant, South Carolina.
How death occurs and how it is managed by physicians—their presence or absence, their words said and unsaid—can dramatically affect the grief and bereavement of patients and family members. I still remember the physician's words to me: “Our hope is that she’ll go home, albeit with her arm amputated.” Pamela, the mother of my 2 daughters and a woman with whom I spent 30 years, lay dying, kidneys and heart failing, left arm and right hand gangrenous, petechiae painting her skin, eyes closed halfway to heaven, and she was going home after amputation of her arm? Really? Oh how me and my 2 daughters wanted to believe that, we really did. Mom was coming home, some semblance of normalcy was returning. But she did not come home—she was dead within 72 hours. I should have known, but patients and families analyze words, and that is what I did, I analyzed 12 words that resonated with my heart: “Our hope is that she’ll go home, albeit with her arm amputated.”
Rousseau P. Ten Values Reprised. Arch Intern Med. 2012;172(15):1178. doi:10.1001/archinternmed.2012.2521