Most of the time, therapists grieve their patients’ deaths in private. Who could I talk to about Julie’s death other than my colleagues in my consultation group or Wendell? And even then, none of them knew her the way I did or the way her family and friends (who get to grieve together) did. The therapist is left to grieve alone.
Even at the funeral, there are confidentiality issues to consider. Our duty to protect our patients’ confidentiality doesn’t end with death. A wife whose husband has committed suicide, for instance, may call up her husband’s therapist to get some answers, but therapists can’t breach that code. Those files, those interactions, are protected. Similarly, if I attend a patient’s funeral and somebody asks how I knew the deceased, I can’t say I was the therapist. These issues come up more in unexpected deaths—suicide, overdose, heart attack, car accident—than in situations like Julie’s. After all, as therapists, we discuss things with patients—and Julie and I had discussed her wish that I attend the funeral.
“You promised you’d stay with me to the end,” she’d said with a sideways grin about a month before she died. “You can’t abandon me at my own funeral, can you?”
In Julie’s last weeks, we talked about how she wanted to say goodbye to her family and friends. What do you want to leave with them? What do you want them to leave you with?
I wasn’t talking about transformative deathbed conversations—those are mostly fantasies. People may seek peace and clarity, understanding and healing, but deathbeds themselves are often a stew of drugs, fear, confusion, weakness. That’s why it’s especially important to be the people we want to be now, to become more open and expansive while we’re able. A lot will be left dangling if we wait too long. I remember a patient who, after years of indecisiveness, finally reached out to his biological father who had been seeking a relationship, only to be devastated to learn that he was lying unconscious, in a coma, and would die within a week.
We also place undue pressure on those last moments, allowing them to supersede whatever came before. I had a patient whose wife collapsed and died in midconversation, as he was being defensive about not doing his share of the laundry. “She died mad at me, thinking I was a schmuck,” he said. In fact, they’d had a strong marriage and loved each other deeply. But because this one argument became enshrined as the final words they exchanged, it took on a significance that it wouldn’t otherwise have had.
Near the end, Julie fell asleep more often during our sessions, and if before it seemed like time stopped whenever she came to see me, now it felt like a dress rehearsal for her death; she was “trying on” what it would feel like in the stillness without the terror she had of being alone.
“Almost is always the hardest, isn’t it?” she said one afternoon. “Almost getting something. Almost having a baby. Almost getting a clean scan. Almost not having cancer anymore.” I thought about how many people avoid trying for things they really want in life because it’s more painful to get close to the goal but not achieve it than not to have taken the chance in the first place.
During those luxuriously quiet sessions, Julie said that she wanted to die at home, and for our last few sessions, that’s where I saw her. She had surrounded her bed with photos of everyone she loved, and she played Scrabble and watched The Bachelor reruns and listened to her favorite music and received visitors.
Finally, though, even enjoying those pleasures became difficult. Julie told her family, “I want to live, but I don’t want to live like this,” and they understood this to mean that she would stop eating. She was no longer able to eat most foods anyway. When she decided the life she had left wasn’t enough of a life to sustain, her body naturally followed suit, and she was gone within days.
We didn’t have a profound “grand finale,” as Julie had been calling our final session. Her last words to me were about steak. “God, what I would give for a steak!” she said, her voice weak and barely audible. “They better have steak wherever I’m going.” And then she fell asleep. It was an ending not unlike our sessions, where even though “our time is up,” the conversation lingers. In the best goodbyes, there’s always the feeling that there’s something more to say.
I’m astounded—though I shouldn’t be—by the turnout at Julie’s funeral party. There are hundreds of people here from all parts of her life: her childhood friends, her summer-camp friends, her marathon-training friends, her book-club friends, her college friends, her graduate-school friends, her work friends and colleagues (from both the university and Trader Joe’s), her parents, both sets of grandparents, Matt’s parents, both of their siblings. I know who they are because people from all of these groups get up and talk about Julie, telling stories of who she was and what she meant to them.
When it’s Matt’s turn, everyone goes silent, and sitting in the back row, I look down at my iced tea and the napkin in my hand. IT’S MY PARTY AND YOU’LL CRY IF YOU WANT TO! it says. Earlier I’d noticed a big banner that read I STILL CHOOSE NEITHER.
Matt takes some time to settle himself before he speaks. When he does, he shares an anecdote about how Julie had written a book for him to have after she was gone, and she titled it, The Shortest Longest Romance: An Epic Love and Loss Story. He loses it here, then slowly composes himself and keeps going.
He explains that in the book, he was surprised to find that near the end of the story—their story—Julie had included a chapter on how she hoped Matt would always have love in his life. She encouraged him to be honest and kind to what she called his “grief girlfriends”—the rebound girlfriends, the women he’ll date as he heals. Don’t mislead them, she wrote. Maybe you can get something from each other. She followed this with a charming and hilarious dating profile that Matt could use to find his grief girlfriends, and then she got more serious. She wrote the most achingly beautiful love letter in the form of another dating profile that Matt could use to find the person he’d end up with for good. She talked about his quirks, his devotion, their steamy sex life, the incredible family she inherited (and that, presumably, this new woman would inherit), and what an amazing father he’d be. She knew this, she wrote, because they got to be parents together—though in utero and for only a matter of months.
The people in the crowd are simultaneously crying and laughing by the time Matt finishes reading. Everyone should have at least one epic love story in their lives, Julie concluded. Ours was that for me. If we’re lucky, we might get two. I wish you another epic love story.
We all think it ends there, but then Matt says that he feels it’s only fair that Julie have love wherever she is too. So in that spirit, he says, he’s written her a dating profile for heaven.
There are a few chuckles, although they’re hesitant at first. Is this too morbid? But no, it’s exactly what Julie would have wanted, I think. It’s out-there and uncomfortable and funny and sad, and soon everyone is laugh-sobbing with abandon. She hates mushrooms, Matt has written to her heavenly beau, don’t serve her anything with mushrooms. And If there’s a Trader Joe’s, and she says that she wants to work there, be supportive. You’ll also get great discounts.