Sympathy Cards

I entered my office on Thursday morning expecting to find a sympathy card on my desk. Recently, one of my original patients from intern year had died. Over the course of my career I watched him traverse the stages of retirement, grieve the death of his son and disappear into the unjust world of dementia. When he was younger we would share jokes, stories of our lake houses and bond over our love of watching and feeding backyard squirrels. In the more recent years I rarely saw him. Instead his wife told me about his paranoia and wanderings. Two weeks ago he was admitted to the hospital. His aggressive behavior had become too much for his wife and daughter to handle. I tried to help the residents learn about the person I knew, but my effort seemed lost on them.  

As I rehearsed the words I intended to write to his wife I noticed a second sympathy card on my desk. Thinking this was a mistake, I casually opened the card and was saddened to see it was not a duplication error. A colleague had left this separate sympathy card for me to sign. Another one of my patients had suffered an unimaginable loss.  Her son, in his mid-20s, had completed suicide. I tried to remember her son and came up with few memories of treating him as a child. More clearly, I recalled the many stories his mother shared about his challenges and successes as he moved away from home. She joyously told me about the birth of his son. I connected with my own maternal knowing and felt devastated. How could I comfort her? I knew words in the sympathy card would not alter her grief, but they could offer her support and open a door into the new phase of our relationship.

I am not sure how many other physicians write sympathy cards. I modeled this habit after another faculty that has since retired. Initially, the office sent a card with the staff and physician signatures to deceased patient families.  We used to have stacks of them and sign them in bulk ready for distribution. Though this was a nice gesture it felt something akin to the mass holiday card that a corporation fills out. My approach changed after my father died. Among the dozens of cards my mom received, one stood out. It was a personal note from his cardiologist of 30 years. He commented on the decades he had spent with my dad, their mutual love for the sport squash, and the life changes they had both gone through. He shared his sadness with us. His simple handwritten card showed me how my dad’s life had affected his.  

How many sympathy cards have I signed over my nearly 2-decade career? When I pause and reflect deeply I can always remember the patient faces. Writing sympathy cards has become a ritual for me.  It brings closure to the relationships I had and helps me reflect on the gifts those patients have shared with me; the stories, the companionship, and the learning moments. I can mark my progression as a physician by their life events. I make it a point to share these details with the patient’s loved ones. Patients’ stories overtime become interwoven with my own. Sympathy cards have become my way of letting others know this too.