The couple's first child was going to be born with an open spine defect which would result in lower extremity paralysis as well as bowel and bladder dysfunction. In addition, the spinal defect was creating an abundance of fluid in the brain's ventricles and causing considerable pressure and damage to the brains substance inexorably leading to serious mental retardation. If their child survived it would require numerous complicated operations as well as life-long custodial care.
Explaining the facts to this newlywed and frightened couple was not easy. They, like many of us, were brought up with the notion that they would someday marry, live in a house surrounded by a picket fence, have healthy children and raise them to be productive citizens, and eventually end up playing with their grandchildren.
Suddenly, their dream was shattered and a new reality crept in. The world, as this couple knew it, was now totally changed. Despite their young age and inexperience they were somehow going to have to find the strength, courage and will to carry on.
As I watched their expression and body language during our discussion, I could sense that my patient and her husband were not only feeling helpless and lost, but also confused. How could this be happening? I realized that this couple needed help and support through this difficult time and so I asked them where they found comfort and peace in their lives and to whom or where could they turn in such troubled times? They did not know. They had no such person or place to go for help. Simultaneously they began to cry.
This tragic scenario is repeated all too often in doctor's offices every day in this country as people are told news of serious illness or impending death for themselves or a loved one. How do individuals handle these tragic events? Where do they find the courage and strength?
I have asked many people this question and I have received an assortment of different answers. The vast majority of those who acknowledge having a place where they seek to find strength and courage to handle adversities identify their religion and family. Wrapping oneself in the blanket of warmth given by one's religion and close family ties is often the key to opening doors to peace and acceptance.
True friendship is often another support system utilized by troubled people. Yet, these nurturing and comforting support systems often need augmentation in the form of isolated reflection. Religion, family and friends are not the only helpful paths for patients to take in order to reach a level of acceptance and peace.
Long solitary walks on the beach, hiking into the mountains or through a park, a day spent fly fishing, sitting alone on the back porch watching the sun go down and rise again hours later, jogging on familiar paths, or lying on a blanket in the middle of an open field looking into the heavens are a few examples patients and friends have said they use to reach inward and reflect on all the feelings and thoughts generated by a lifetime of feeling and thinking. It is through these special times alone that many find inner peace and strength.
It seems to me that, regardless of our age, we should prepare ourselves for that inevitable moment in our lives when somewhere, sometime, someone will say to us "I'm sorry to have to tell you this."
(Frank H. Boehm, MD is a professor of OB/GYN and Director of OB at Vanderbilt Medical Center in Nashville, TN. He can be reached at his web site http://dr-boehm.com. Dr. Boehm resides in Boca).