Genuine Encounters: Responses to Death
Authors: Robin K. Matsuyama
Journal: Journal of Clinical Oncology (2005)

“In genuine encounter, both persons are changed, however minutely.” —R. May Five years ago, I sat by my husband in the infusion area while he received chemotherapy for advanced gastric cancer. His oncologist always skillfully and sensitively blended truth with hope, so while we may not have completely understood what death meant, we did know that he was dying. That knowledge helped us accept death as it approached. Even while our primary focus was on my husband and his illness, we wondered about the professional caregivers. We knew very little about them; did they know us? How did they endure participating in personal tragedies such as ours, even if those tragedies were punctuated with successes? In every encounter we found compassion, patience, kindness, and care. What did they really think about their patients? How did they feel when one of their patients became sicker or died? Immediately after my husband died at home, his oncologist spoke to me on the telephone. I thought that was brave of him. I’m not sure I would have wanted to speak to me without knowing what to expect. In fact, my husband’s death had been very peaceful, and even beautiful, and I was feeling transcendent, as though we had accomplished something remarkable after a strenuous journey. I recall very little of the conversation except that the physician sounded sad. It felt genuine and I wanted it to be genuine. When I received condolence letters from each of the professional caregivers, I was touched. I still have them today. My husband had been a remarkable individual and it was important for me to believe that people cared that he had died. Five years later, I worked as a psychosocial researcher at the same cancer institute where my husband was treated. The intensity of our shared experience had enriched our marriage while he was alive, and ultimately transformed my life. I went from market researcher to receiving a PhD in psychology, with the topic of my dissertation being “Physicians’ experiences with patients’ deaths: Meaning and connection.” This study consisted of in-depth interviews with physicians talking at length about their responses to patients’ deaths. As I prepared to read the interviews of 140 physicians, I wasn’t sure what to expect. What I found was that most physicians told stories that were beautiful, articulate, and philosophical. Physicians described interactions with patients, families, and other health care providers. They spoke of conflict and comfort, caring and grieving, spiritual beliefs and personal feelings, and transitions from life to death. Each physician brought a separate and authentic voice to the experience of death. On the most basic level, the physicians showed that they cared about their patients. They also were moved and sometimes even changed by their experiences. One attending physician described her feelings by saying, “So there’s always some sadness, regardless even if it’s one where you know the outcome could not have been any different. It’s just that connection—that human connection.” A resident quietly sat with a patient as she died and talked about witnessing the family’s love and caring, and the patient’s last breath. Then he said, “But I remember From the Massey Cancer Center, Virginia Commonwealth University, Richmond, VA.