A Mother’s Warning

She is tearful. She tells the nurse her urine stings; that’s what brings her here today. “This is her third visit in five days,” the nurse whispers to me as I walk in the room.


“Let’s check your urine for any infection,” I say to my patient, “but while we do that, can you tell me what else is going on?” As I talk, I gently take the hand of this frail, 82-year-old woman. She is dressed in black with a scarf over her head; she appears to be grieving.

“My son is dead.” She starts to cry and I sit with her as she remembers her baby. “He died alone, he overdosed.”


“He was a good boy, my baby,” she explains, as if trying to assure me the overdose was not his fault. I feel helpless and overwhelmed. I continue to listen and hold her hand, not knowing how to express my sympathies. Losing a child is a parent’s worst nightmare.

“My son worked in construction. He had a shoulder injury 4 years ago and got pain medicine from his doctor. That’s how he started,” she tells me, blue eyes swimming with tears.
“I don’t know when he got so dependent on his medicines but as he had a difficult time working without them, he lost many jobs. He moved in with me to save money and rent. We lived together, gave each other company. I loved hearing him move around upstairs and eating dinner with him.” She sits there wringing her hands. I am heartbroken, but can only offer her my silence.

“I just found out about his addiction 3 months ago. I heard a thud upstairs and found him unconscious on the floor. He wouldn’t wake up. I called 911—they came quickly. On the way to the hospital, the paramedics told me they gave him Narcan. That’s when I found out he was a drug addict using heroin.”

My role as a physician now is just to listen. Sharing her grief, and allowing her to talk will help her heal, I hope.

“He came home, promised me that he would not use drugs anymore.” Again she pauses and scans my face to check if I am still paying attention. “He was my youngest, the baby after four children. I still remember the day he was born.” She smiles as she remembers that precious moment, holding her newborn who is now dead.

“After his first overdose, I insisted he follow up with his primary care doctor. She got him into a methadone program, said that would help him.”
 I watch her wiping tears that flow silently down her face, and I am divided between worrying about other patients waiting for me and the concern I have for her well-being. In the end I feel privileged to be connecting with her, and stay.

As I continue to listen to her story, my initial feelings of helplessness and inadequacy dissipate. I want to fix her sorrow, to change this awful situation, but that is not possible. As I look to treat her physical symptoms, I realize I am already giving her all she needs. My time of 20 minutes is what she wants; she is coming in every other day to our urgent care, so that she can talk and someone will listen.

“He was my baby boy. I miss him so much. I have nobody at home now. My house is silent.” She pauses a moment, her words falling like stones into my silence.

“Do you have children?” she asks, looking at me.


“Yes,” I respond, feeling a surprising premonition of dread.
“You be careful, keep them safe,” she warns me. I hear my own mother’s voice in hers. “It’s a bad world out there. My son was in his 50s. I thought I was done parenting and look what happened.”
I hold her hand and let her talk. The nurses get her some ginger ale and crackers. She waits while I see a few more patients and then come back to her. She leaves with her paperwork but her warning lingers on.

As I move on, seeing more patients, treating coughs, sore throats, back pain, I have a heightened awareness of how my prescribing practices affect patients, families, and communities. I understand even more the effects of illnesses and addiction on families and society. At night tucking in my children, kissing them goodnight, hearing their chatter, I am grateful to have them lie in their bed, and remember another mother’s empty nest.