"Hello, Doctor, this is the Cheryl Smith at the Smith Funeral Home. Would you be willing to sign the death certificate for Susan Jones, a patient of yours who died during the weekend?"
"Oh no, I wasn't aware, what happened to Ms. Smith?" I ask as I see Cheryl Smith in my mind's eye and reflect on the last time I saw her a few weeks ago. I don't recall that she was ill.
"Her husband said that she fell on the ice striking her head and losing consciousness. She started to seize, he called the squad. She never regained consciousness and died in the emergency room. They told him she probably bled into the brain."
"That's really sad," I say while feeling a bit empty. I think-- I need some time to reflect on this unexpected loss. Where do I go? I'm interrupted by one of my office staff, "Dr., Here's Mr. Samuels INR result, is it OK?" I look at the numbers and the note about Mr. Samuels, reflect on the results and write a few numbers and a comment. The Medical Assistant says, "Thanks, Your first patient is in the room, coughing. She may need a breathing treatment."
I take a deep breath, hold it for about five seconds, grab the medical file from the rack outside the first room, read the MA note and vital signs and problem list and glance at the last note I wrote about this patient, knock and enter the room.
When is my grief time for Susan Jones? Maybe tonight after seeing the last patient.
Family Medicine: We'll Cry Later.