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Some of our professional skills don’t work well when it’s family.

Fam Pract Manag. 2022;29(6):4

One phone call. That’s all it takes to turn life upside down.

“Your mom’s not doing well. Hospice is here now,” my dad said to me, a subtle tremble in his voice.

The timing couldn’t have been worse. (Is there ever a good time for a call like that? Probably not.) I was 15 minutes away from moderating a discussion panel at this year’s FMX, the AAFP’s annual meeting. I had mere moments to wipe away my tears, get the quiver out of my voice, and act like everything was normal.

As a family physician, I’ve many times gotten shocking information (“Just wanted to let you know that Mrs. Smith died earlier today”) and then had to act calm and go see my next patient (“Hi, Mr. Jones. How was vacation in Hawaii?”). I think I’ve mastered walking that fine line between cool professionalism and genuine empathy.

Those skills don’t work well when it’s family.

My mom was diagnosed with colon cancer earlier this summer. She was incidentally diagnosed, by the way. Her rheumatologist noticed a very mild anemia on a routine complete blood count. You know how the story goes from here. Heme positive stools. Colonoscopy showed a mass. Shared decision making on treatment options. Surgical excision. Good news — stage two and nothing other than surveillance is indicated! Things were looking up.

And then (there’s always an “and then,” it seems) the post-operative complications began. She spent weeks going in and out of hospitals, ICUs, and rehab. Pneumonia. Pneumothorax. Urinary tract infection. Sepsis. Bleeding. Finally, COVID.

At that point, I had a decision to make. I was scheduled to fly to Washington, D.C., for the first in-person FMX since 2019. For those who’ve been to FMX, you understand my struggle: FMX is great! The CME, networking, and learning opportunities are boundless. Each year, I find new tools to add to my clinical toolbox that help me take better care of my patients. And I love being a family physician, so being with thousands of my colleagues recharges those passions.

I decided I would still go, but I would drive. D.C. is only a six-hour drive from Akron, and that wayI would have more flexibility to leave if I had to. Plus, the latest report was that my mom was doing a little bit better. Deep breath. It’s going to all work out. I canceled my flights and jumped in the car.

The first day of FMX was everything I remember from the past — energetic, fast paced, engaging, great opportunities for both professional and personal enrichment, and the weather was great! My mood was lifting.

And then, that phone call.

The next morning, I was in the car on the way back to Ohio. I was going to miss the last two days of FMX, which was disappointing. But I couldn’t stay; my mom needed me. There’s something about the drive home from anywhere that is inherently depressing. This drive was no different, times an order of magnitude. I was agitated, hangry, scared, and alone. It was not a good combo. Fortunately the time in the car allowed me to reflect. My favorite author is Kurt Vonnegut. In his arguably most famous tome, Slaughterhouse Five, the main character Billy Pilgrim becomes “unstuck in time” and sees time not as a flowing from one moment to another, but rather as a collection of moments to be experienced in any order. “So it goes,” Billy learns to say when hearing that someone has died, as that’s just another event in the jumbled timeline. Years later, when asked about this, Vonnegut explained:

“When a person dies, he only appears to die. He is still very much alive in the past, so it is very silly for people to cry at his funeral. All moments, past, present, and future, always have existed, always will exist. It is just an illusion we have here on Earth that one moment follows another one, like beads on a string, and that once a moment is gone it is gone forever.”

I’ve always found comfort in that. I thought a lot about that on the drive home.

I made it home in time to say goodbye.

A day later, my mom died. Quietly, peacefully, and painlessly. It was a sad ending to a summer of suffering, yet what I’m left with are the good moments. She was a wonderful person. She had a heart of gold. She was funny and caring and kind. She taught me humanity.

She might not be here now, but she’s still here.

So it goes.

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