You Should Make Arrangements

I will always remember these words. When I was a freshman in college my father died from liver failure due to infectious hepatitis.  He and two of his brothers had contracted this insidious disease as young boys while swimming in water too close to our local sewage treatment plant. Although the slow progression of his illness provided me many years of opportunity to prepare for his death, I stood transfixed next to my mother when we were told it was time to make arrangements.  I never forgot these simple words.  I walked down the hospital corridor and found a side stairwell and cried.

Although I have heard these words many times throughout my medical care it took many years to understand them.  A mother recently recounted to me how a neonatologist told her the death of her premature infant was near and she should begin to make arrangements.  Her eyes filled with tears and then she suddenly began to smile.  She proudly told me her son survived and was now grown and healthy. In that moment I again understood the meaning of those words.

A parent’s life is filled with joy bordered by fear and the risk of loss. We listen and watch as our children say their first word or take a first step. Her eyes are sprinkled with a realization she does not know how to get down. We remember driving tests, first dates and the morning after the prom. We live for times of safety and security and avoid the fear.

This mother reminded me about the depth and power of words.  As a neurologist and pediatrician I have spoken with many parents whose child was near death. I tried to listen, console, explain and prepare them for the impossible, the death of their child. I believed compassion and understanding would be the gateways to solace for parents. I believed my saying the right words could prepare parents for their child’s death. I was wrong.

I now believe death is best prepared for not by words but rather by choice and understanding.  Our beliefs and attitudes provide the necessary and unending power to seek and find healing and understanding from within.