Processing Loss: As Many Questions as Answers
Part of being a neurosurgeon is internalizing a sense of invincibility. Without this, it is difficult to manage the multiple conflicting responsibilities, weighty decisions regarding people’s neurological health, surgical stress, work schedules few others understand and the sense of almost always being “on.” We simply keep going, managing our practices and taking care of people as best we can, without thinking it could suddenly end.
Death Comes Knocking
When my partner, Chris Getch, MD, FAANS, passed away suddenly in 2012, it was the first time I took pause and considered the fragility of our lives. Chris was a superlative surgeon, clinician and partner. I was the last of our department to speak with him, as he had come in on a Sunday (the day before he died) when I was on call, to clip a ruptured aneurysm in a young woman. I had called him that night to thank him for taking time on a weekend when he was not on duty to do the case. As always, he said it was nothing and said he would see me tomorrow. I grieved for his untimely passing, but Chris was almost a decade older than me. So after a pause, I essentially returned to life as usual, always keeping his advice and teachings close to me, but again being absorbed by the torrent of activity that is neurosurgical practice.
While I could compartmentalize and rationalize Chris’ death, nothing prepared me for January 20, 2015. I had just finished a case when I checked my phone and saw a text from one of my close friends asking me if I had heard about a surgeon in Boston being shot. It asked, “Was that your best friend and medical school roommate, Michael Davidson?” With my heart pounding, I called another of our medical school classmates who is a surgeon in the Boston area. She said that she had heard the news and was waiting to hear confirmation from colleagues at the Brigham, where Michael was the director of the Endovascular Cardiac Surgery Program. Tragically, it was confirmed that Michael had been shot multiple times by the disgruntled son of a former patient. The assailant inappropriately blamed Michael for his mother’s death several months prior and came to the clinic, ostensibly to talk to Michael, but with a loaded gun and having left behind notes in his home about killing him. After shooting Michael multiple times in the abdomen and chest while they were alone in an exam room, Michael ran out, already fatally wounded, alerting the rest of the staff about the shooter, who subsequently took his own life in the exam room. Hours of emergency surgery and heroic attempts to repair his shredded abdominal vena cava were unsuccessful and Michael died in the OR that day, leaving behind 3 children and a wife who was pregnant with their fourth.
Michael and I
Michael and I met during med school orientation and lived together for our final three years of school. We were each other’s best men in our weddings. Our families vacationed together. Despite our differing specialties, our careers and lives paralleled each other – academic positions starting new programs at our respective institutions, while trying to balance clinical and academic responsibilities with growing families and marriages to professional women just as busy as we were. We would speak during the small amounts of free time our lives allowed – driving home from work, walking our dogs – and commiserated about random things that happened, frustrations with surgical careers and how the hell were we going to make all this work, anyway.
His loss left a deep hole in my life. While I had a circle of close friends and a wonderful spouse to support me, the specific niche he occupied was empty with nothing to fill it. Yes, I could talk to others about the things he and I would discuss but no one had the same common baseline that we had.
Death Knocks Yet Again
Unfortunately, I had not even really processed Michael’s death when another shock hit me. About two months later, Andy Parsa, our department chair, died suddenly, much as Chris Getch had done several years prior. Andy and I had met on the interview trail for neurosurgery and had become close during his two years as chair. He was very supportive of my career and programs and we had developed a solid friendship. We would often hang out while our kids played soccer on adjacent fields, alternating our attention back and forth between the games and discussing department and life events.
These dual impacts, coupled with the loss of Chris, rendered my shell of invincibility null and void once and for all. These were people with no warning of what was about to befall them. Their families could not plan or brace themselves for what was to transpire. There was just the sudden imposition of a sharp, cold, harsh dividing line between the life that was and the life that is. Reconciling this was incredibly difficult for me.
Unfortunately, neurosurgery (and life in general) does not always provide us with space to process events like this. So much of my adaptation has been on the fly, with some efforts more successful than others. In the end, I have not succeeded in some ways. The hole in my life left by Michael’s loss remains. There are still more times than I like to admit that I want to speed dial him and run something by him for advice, or tell him about a humorous event, either professional or personal. His wife has remarried and our families still get together, Michael’s memory never far.
While I can never replace what I have lost, I have found that the best way I can manage things is to try to honor the principles by which these fantastic individuals lived and incorporate them in my life. Michael was a multitalented individual who loved learning new things and venturing in the outdoors. Andy had a joie de vivre that he spread to all around him, always opening his house for rousing dinners that seemed celebratory, even on an ordinary weeknight.
In the years since these tragedies, I have regularly organized a dinner on the Sunday night of all national neurosurgical and functional section meetings. I am so fortunate to have a wonderful group of friends in neurosurgery. It allows us to gather over good food and talk about life and families in a setting other than hotel conference rooms, while remembering how fortunate we are to have each other and to do what we do every day. I still wear the button created for Michael’s memorial on my white coat, both to keep his memory close to my heart and because people ask me about it and this gives me an opportunity to tell others about how a remarkable a person he was. Along with some of my medical school classmates, I helped establish a lectureship in his name to bring a physician speaker to specifically discuss some area of interest and expertise of theirs that is outside medicine, reflecting Michael’s diverse talents.
These efforts all have helped direct some of my sadness in positive directions but there are still difficult times, such as when I am on Concourse C at O’Hare airport. Michael and I had just returned from a spectacular weekend fly-fishing the Yellowstone River in Montana in October 2014 and he was heading to his connecting flight to Boston. We said so long, hoping it would not be long before we got together again, not knowing that time would never come.
Kranzler Chicago Review Course in Neurosurgery
Jan. 24-31, 2020; Chicago
46th Annual Richard Lende Winter Neurosurgery Conference
Jan. 31-Feb. 3, 2020; Snowbird, Utah
Third Annual Cedars Sinai Intracranial Hypotension Symposium
Feb. 8, 2020; Los Angeles
2020 Managing Coding and Reimbursement Challenges
Feb. 14-16, 2020; Las Vegas
13th Annual International Symposium on Stereotactic Body Radiation Therapy and Stereotactic Radiosurgery
Feb. 21-23, 2020; Lake Buena Vista, Fla.