20 ms·

How to Tell a Mother Her Child Is Dead

• helloworld 10y ago
  Security is already outside the room and when they hear the first loud noise they will know to come in. No, you will not have to tell them. They know about the family room in the emergency department in summer in North Philadelphia. What a heartbreaking essay. And how tragic that death by gun violence is apparently routine in North Philadelphia.
  • yial 10y ago
    "We have money for new chairs every summer." Really feels to me like it drives that point home... I remember reading an anecdote somewhere that when it's hot out (temperature wise) that physical altercations increase.
    • fredgrott 10y ago
      most USA city jails pipe in cold air during summers..under 60f due to such things
    • cyberferret 10y ago
      > I remember reading an anecdote somewhere that when it's hot out (temperature wise) that physical altercations increase. The 'build up' to the wet monsoonal season where I am in tropical Australia is well known as 'Mango Madness' season (it coincides with the mango fruiting season). I have two sisters in the police force, my dad was a doctor and my wife is a psychologist. They all concur that the rate of murders, assaults, domestic violence, divorces, street violence, car accidents etc. all dramatically increase during these couple of months.
      • emilga 10y ago
        When I went on a guided tour through Dubrovnik the guide said -- and I'm paraphrasing her from memory -- that assaults carried more lenient sentences during the warmest parts of summer. Looks like being cool-headed is more than a metaphor.
      • ageofwant 10y ago
        Mate from Darwin calls it "suicide season".
    • artursapek 10y ago
      > I remember reading an anecdote somewhere that when it's hot out (temperature wise) that physical altercations increase. This is actually a joke among New Yorkers. Random slashing in the news in May? "Well, it's getting warmer out..."
      • atom_enger 10y ago
        Unfortunately it's kind of a joke here in Chicago too. You'll hear everyone saying "Suns out guns out" and crap like that. Especially holiday weekends are the worst. I'm not sure why it's this way, but I have a cop neighbor and he tells me summer holiday weekends are the worst for the force. Tons of overtime to be had and tons of hooligans shooting each other. This year the police union told the officers not to take overtime [1]. Unfortunately I'm worried it will end up in more shootings. 1. http://wgntv.com/2016/09/01/police-union-tells-cops-to-avoid-overtime-over-labor-day-weekend/ http://wgntv.com/2016/09/01/police-union-tells-cops-to-avoid...
        • jackvalentine 10y ago
          Heh, "suns out guns out" in my part of the world means you can wear tank tops to show off your muscles 'guns'.
        • addicted 10y ago
          For all the flak Chicago gets in the news for gun deaths, on a per capita basis it's fun death rate is actually a lot better than many other cities in the US. http://www.citylab.com/politics/2013/01/gun-violence-us-cities-compared-deadliest-nations-world/4412/ http://www.citylab.com/politics/2013/01/gun-violence-us-citi...
      • rdtsc 10y ago
        In one of the machine learning classes we looked at crime data in our city and discovered interesting patterns in how crime seemed to migrate with the seasons. It increased in the summer in some areas, then decreased and moved in the colder months.
        • 10y ago
    • nwjtkjn 10y ago
      I always figured this was because when it's cold out, people simply go outside less.
      • 35bge57dtjku 10y ago
        They also go out less and there's less crime when it's raining.
    • danielvf 10y ago
      There's actual data on this. The correlation between summer and increased violent crime is real. http://www.bjs.gov/content/pub/pdf/spcvt.pdf http://www.bjs.gov/content/pub/pdf/spcvt.pdf
      • tamana 10y ago
        Spike Lee's first famous movie was about this.
        • mturmon 10y ago
          And it captures the feeling of heat putting everyone on a hair trigger very well.
        • chronolitus 10y ago
          For those wondering - Do the Right Thing (1989)
      • cornholio 10y ago
        Luckily, defensive fire arms still work ok in the summertime. (sorry for the cheap joke, european here, I still can't relate to the american reality where people run around with fire arms killing each other and you somehow need to blame it on the weather)
        • late2part 10y ago
          I resent your cheap and illogical attack on my country and my people. I'm an American and I don't run around with firearms killing people. More crimes happen in the warmer months because more people are active, outside, and interacting with each other. See this data from the UK And this graph [2] [1] http://www.ukcrimestats.com/National_Picture/ http://www.ukcrimestats.com/National_Picture/ [2] http://imgur.com/a/Qxm4F http://imgur.com/a/Qxm4F
• bennettfeely 10y ago
  I just want to say the style of the article and it's direct, terse language really captures the gravity of the situation and seriousness of the subject. Very sad, but very well written.
  • themartorana 10y ago
    Two years ago and a day, I could read this and understand the gravity. Two years ago my daughter was born, and now I can't read this, or see commercials from CHOP, or anything else similar without my eyes filling with tears. I don't know how people lose a child and come back from it. I say I can't imagine, but I do, and it terrifies me.
    • alasdair_ 10y ago
      They don't. They are different people. Their old life ended the day their child died.
      • spydum 10y ago
        Indeed this is pretty close to it. It's funny the things which can throw you off too. Striking up a conversation with someone and they ask how many kids you have, or if you are going to try again for that boy or girl. Sometimes it's easy, but Some days it will tip your emotional canoe more than you were expecting.
      • chris_wot 10y ago
        I can't even begin to imagine your pain. It's inadequate, but I'm so sorry for your loss.
    • manyxcxi 10y ago
      Exact same boat. My entire life I would consider myself stoic, just generally not moved to tears for anything. I've felt sad, tremendously sad before about things that have had other people losing their minds around me, but crying never really seemed part of my process. Then the first child came and I can't stand more than a passing glance of kids in war torn areas or have to shut off a news clip where some monster did something awful to a child. My blood boils and my heart shatters nearly instantly. 1 second after my first child was born I realized I had only two fears for the rest of my life: not being a good enough dad and living longer than any of my children.
• ghufran_syed 10y ago
  "The depth of the stupidity of the things you will say sometimes is unimaginable." -I'm pretty sure everyone who has ever had to do this has felt the same way.
• Kenji 10y ago
  Wow, that was surprisingly moving. For some reason, I expected one of those dry hacker essays.
• CapitalistCartr 10y ago
  I had to tell that to my own mother. It was 5 years ago this week. There are no good ways. There are no good outcomes. This is a good article about how bad it is.
• hoodoof 10y ago
  I had to tell friends that one of our closest friends had passed away. The only thing I would add to this article is to invite the recipients of the news to sit down first because there's a good chance they'll fall down.
  • JshWright 10y ago
    That's why you, as the person delivering the news, sit down. It invites the family member to sit down without the awkward "Why don't you sit down..."
• jkot 10y ago
  > Security is already outside the room and when they hear the first loud noise they will know to come in. My impression is that security was not there by accident. Is it common in US to call security on such occasion? It is not very sensitive and respectful to bring such news with gorillas behind your back.
  • ryanlol 10y ago
    >It is not very sensitive and respectful to bring such news with gorillas behind your back. No, but it might be smart. edit: really? The article fully explains why it is good for them to be there.
  • cldellow 10y ago
    The next sentences confirm that they are not there by accident: > They know about the family room in the emergency department in summer in North Philadelphia. It is all right. They will be kind. This article is discussing murder victims and people who died from violent crimes. They talk about barring the family from the body so the police can inspect it. In such circumstances, it seems understandable that people may react strongly. How would you feel if you just learned that your loved one was (a) dead and (b) you aren't allowed to see them? Having security on hand, but out of sight, seems prudent.
  • wtbob 10y ago
    U.S. hospitals serve people of all classes; people with low impulse control are positively correlated with the criminal classes; people with low impulse control are more likely to behave impulsively when given bad news. It's unfortunate, but true. I have a few acquaintances who work in hospitals; it's quite amazing how the people they see in the course of their work differ from those I encounter in the course of mine own.
    • PhasmaFelis 10y ago
      To put it even more simply: people under stress sometimes do unwise things, and little is more stressful than the first throes of grief. Planning for this is how you protect them from the potential consequences of their own grief-stricken rage.
• mastre_ 10y ago
  > I just want to say the style of the article and it's direct, terse language really captures the gravity of the situation and seriousness of the subject. Quick comment about how your it's instead of its caused an English parsing error in my brain: I read until the comma and because I saw it's, I assumed I missed a word in the first part of the sentence - I though it may have been something like "I just want to say I evaluated the style of the article and it's direct, it's frank, it's spot on!", but re-reading it didn't reveal anything I missed. I then considered some less common writing styles/expressions. None of that worked out, so I read past the comma and figured out what happened. All this happened in the span of a second or so. Not sure what it was about this particular sentence that caused me to stop at the comma, I don't think it happens often.
  • sctb 10y ago
    We detached this comment from https://news.ycombinator.com/item?id=12421811 https://news.ycombinator.com/item?id=12421811 and marked it off-topic.
  • c22 10y ago
    I had the same problem when I read "I though..."
  • grkvlt 10y ago
    FYI, they are called 'garden path sentences' - https://en.wikipedia.org/wiki/Garden_path_sentence https://en.wikipedia.org/wiki/Garden_path_sentence
• deleted 10y ago
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• gjolund 10y ago
  Not saying it wasnt a well written article, but why is this on HN?
  • Chinjut 10y ago
    The submitter presumably thought some HN readers would find it interesting, and it turns out they were right.
  • sotojuan 10y ago
    Someone who has been here for 400 days should know non-tech articles get posted and are accepted here as well.
  • throwanem 10y ago
    Are hackers not human, sir? Have we no hearts? May we not cry? We make a world not only for ourselves. In so doing we must above all else be kind. We must not lose sight of what and who we are, lest we invent cruelties beyond any yet known to history. May God forgive us if we fail in our charge - for no one else will. Nor should they.
  • protomyth 10y ago
    Because even HN readers might need this advice, or wish we had when the time came. Software lifecycle isn't the only lifecycle we will have to deal with.
• jrapdx3 10y ago
  A subject I understand more than I can put into words. It's a duty I have had. A 17 year girl died of an overdose. It was my responsibility to tell the mother, father, pastor, brothers, sister. They were there all night in the tiny, chilly waiting room, after notified their comatose child was brought in. Some kind of party had been going on when mom and dad were out for the evening. The young woman and assorted friends doing drugs. She passed out, it was hours before anyone thought to check out how she was. I called in all the docs there were to call. We tried every trick there was known to try. Then heart rate fell to zero. All the effort came to nothing. Everyone was quiet, mumbled their sorrow, and slipped out the private staff access door. That is everyone but me. That morning was about the hardest I ever faced, even in the decades since. Sure others have died on my watch, one cause or another. But that time was different. I knew I had to say it, give the worst possible news, the unnecessary death of a child, to grieving parents. I truly did not know how such a thing can be said, what phrasing is best, what stings the least? I don't know how, but summoning the courage I walked out to where they were sitting. I was nearly in a trance, not only from lack of sleep, but stunned by the magnitude of what I had to speak. And I said what happened, the child passed away, never awakened despite the heroic efforts of so many healers sweating all at once. I sat there for a moment, no more to say, listened to the mournful sobs. Though I felt a failure, more than anything I had no comfort to provide. They didn't find fault, they were not angry that we could not do more. Seriously, a moment too stark, too profound to ever forget nor would I want to relinquish it. No repeat is necessary, the lesson deeply embedded, the value of life, the meaning of words, the merit of a healer's human voice, these are all worth keeping.
  • secfirstmd 10y ago
    You Sir/Mam/Other, make me feel better about the human race. Can't imagine how hard that was, but you did the difficult thing and your best at it in the hardest circumstance I can think of. Thank you.
  • Vaotix 10y ago
    Wow. Thanks for sharing. This was beautifully written. A tragic occurrence that you seemed to have handled well.
• epicureanideal 10y ago
  The article is basically saying not to flip out, but "When you get home, do not yell at your husband. If he left his socks on the floor again today, it is all right." We all know that this doesn't just happen after someone dies on the operating room table. Seriously people, if your spouse is not cheating on you, beating you, or throwing the family money to the casino, lighten up about the little stuff. End of public service announcement.
• cmmn_nighthawk 10y ago
  this makes all debates about software seem trivial. i agree--it's very well written.
• deleted 10y ago
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• deleted 10y ago
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• sndean 10y ago
  Somewhat related - One of the reasons my significant other decided to not go into emergency medicine was the high rates of PTSD in ER physicians and nurses: "We don't have good numbers, but the incidence of PTSD in emergency physicians is probably around 17%" [1]. So while I can respect the stoicism and clear focus on the emotions of the mothers of victims, I hope the author and other ER doctors also take some time for themselves to deal with the trauma they experience. [1] http://www.medscape.com/viewarticle/840980 http://www.medscape.com/viewarticle/840980
• drauh 10y ago
  For some context, here is a map of poverty in Philly: http://www.nytimes.com/newsgraphics/2014/01/05/poverty-map/ http://www.nytimes.com/newsgraphics/2014/01/05/poverty-map/ The hospital is in census tract 016300 with poverty level 58.5%
• alasdair_ 10y ago
  My twenty one year old daughter died two months ago. A young policeman came to my door. It was the first time he had to do the job mentioned in the article and he did it very well. I have very little memory of those first few hours. I now know what it is to be insane. I was so disconnected from reality that people have told me that I had long conversations with them that I have zero recollection of. The only thing I clearly remember was telling the officer that I had a gun upstairs and that if he didn't take it, I was going to murder the man responsible for her death within the hour. It was the most matter of fact confession of planning a murder imaginable. After a couple of hours, I saw a Facebook post of hers and lost it, the insane calm left me and I bawled my eyes out. It's her birthday tomorrow. I miss her so, so much. Anyway, the point of this post: my daughter died of an overdose. She was at a party, a man gave her powdered pure fentanyl claiming it was cocaine. I have no idea why. She snorted some and overdosed soon after. All I want to happen is that someone somewhere reads about what happened to my daughter and reminds their kids that without proper testing kits, they have no idea what the fuck they are taking. Drugs may not be bad, but some people certainly are.
  • tomjen3 10y ago
    Good thing you didn't murder him, he might not have known that wasn't cocaine, and going to jail for that would not have been something your daughter wanted.
    • tomjen3 10y ago
      Sorry that didn't come out the way I wanted
      • yberreby 10y ago
        Why on earth were you downvoted? That seemed like a sensible comment to me.
        • gengkev 10y ago
          The threat to murder was more of an expression of the mother's grief than an actual threat — in such grief and shock, humans tend to want to find someone to blame. In her right mind I'm sure the mother would never truly consider murder.
• FT_intern 10y ago
  Why is this "how to tell a mother her child is dead" instead of "how to tell parents that their child is dead"?
  • JshWright 10y ago
    I have told parents their child has died. It may not be 'right', but in every case, even when both parents are present, I'm talking to the mother. I am a father of three. Were I in those horrible shoes, I'm quite certain I would feel that my wife was the one "being told". Maybe that's just some misplaced "macho" attitude on my part, but it's always been true, in my experience.
    • cperciva 10y ago
      It is certainly a general rule that fathers are not seen as being equal parents; I think FT_intern's point is that they should be treated as equal parents. The headline's casual dismissal of fathers is symptomatic of a societal failing.
      • throwanem 10y ago
        What is this general rule of which you speak? I suspect you of talking nonsense, sir.
        • cperciva 10y ago
          As JshWright said, when there's something to be said involving a child, most people turn to the mother rather than the father.
          • throwanem 10y ago
            My prior comment was ill-considered and unnecessarily combative, for which I apologize. My own experience includes a mother who did in fact mostly raise me, but also a father who was generally feckless in a wide variety of ways. On reflection, I strongly suspect I have based my understanding of parenting dynamics in families with two worthwhile parents primarily on wishful thinking - excusable in a child, perhaps, but not so in a grown adult. I'll keep an eye out for that in future.
• Jamesbeam 10y ago
  I've been a private military contractor for more than thirty years. Some of the companies I was working for had very impersonal procedures to handle deaths. I offered a few times to personally inform the family / next of kin for the guys that were working with me directly but that request was always denied because it was not "cost efficient". So I always did the trip on my own. The loss hit them like a truck every time, I have a few memories that make me wake up in the middle of the night three days a week but the look on a mother's face when you tell her that her son is dead is something you will never forget as long as you live. Still, I am glad I went to see every family of everyone I lost in all those years. There was crying and screaming and tears and a lot of blaming, I even got slapped a few times but I always told them I'll be in a hotel nearby for the next days and if they want to talk they can call me any time of the day. Some never called but after a day or two most invited me back to their home or came by and we had a few long talks over the next days until I had to go. I've been in touch with most of those families over the years and I heard a lot of times that it gave them peace to know that I was there when their son / brother / husband / grandson died and that I came by personally to try to comfort them before they got "the letter". I wish everyone that you will never come into this situation because it's almost as hard and unfair to be the messenger as it is to be the recipient of that message.
  • jayess 10y ago
    Jesus.
  • allendoerfer 10y ago
    This comment will be unpopular. When you have gone through something like that, how can you continue to do the work you do? How can it still be worth it? I do not know what exactly you do, but could it someday be someoneelse telling this to your family?
    • mirimir 10y ago
      Well, you do seem judgmental. If parent had talked about military or police, would you have posed the same question? If not, why not? I'm no pacifist, but I also don't like to follow orders, so I wouldn't do any of that work. And yet, who am I to judge?
• deleted 10y ago
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• emptybits 10y ago
  When I occasionally start to think my work in technology is overly important or that the woes of my startup projects are unbearably heavy, I'm glad I can be humbled by something like this. This doctor has responsibilities and gravity I will never know. Great article and great doctor. Wow.
  • tamana 10y ago
    Heyif, making fun stuff is important. If we didn't have any fun stuff, our lives wouldn't matter and the serious stuff wouldn't be serious.
• mindfulgeek 10y ago
  When I was a year out of cancer treatment, I ran into a fellow patient. She and I had a rare cancer and were treated with a handful of others. Of the three of us who remained, only two of us remained cancer free and she wasn't one of them. A week earlier, there had been five of us. I knew this. I didn't know if she did. I didn't know what I would say if she mentioned them. It was possible she had the same problem in her head. After we caught up, she asked if I had seen one of them. Telling her the truth wasn't nearly as hard as answering her next question -- what about the other girl?
• milesf 10y ago
  I know this will sound cold, but why is this story here? Does it really fit the guideline of "anything that gratifies one's intellectual curiosity"? I've shoehorned it into my rationalization for being here as advice on how to have an extremely difficult conversation, but it still feel a bit macabre to have this here.
  • kctess5 10y ago
    I would say that this does in some way gratify my intellectual curiosity. I hope to never find myself in this situation, but it's good to have some guidelines if I ever do.
• toopersonal 10y ago
  My father died younger than 50 years old when I was a child. My mother was left behind with several small children and financial struggles. On the day of his funeral there was a funeral of an 18 year old boy afterwards. She has told me she consoled his girlfriend and when she saw the young girl standing there crying, she thought that even though her own situation was as bad as it could possibly get, this was even worse. Must have been a strange moment for her. Maybe even a bit uplifting, as perverse as this sounds.
  • hhw 10y ago
    Other people's tragedies can be cathartic, or at least so I recall being taught in high school English class from nearly two decades ago. Knowing that someone has it worse than you do can make you feel better about your own situation, not due to schadenfreude but just by helping to put things in perspective.
  • tbihl 10y ago
    I've been blessed to be very inexperienced with funerals. Two grandparents, an aunt, and a high school classmate. With my grandparents, we knew it was coming and had lots of chances to visit in the preceding year. Granted you always wish you'd done so more, but those ones are relatively easy to handle and feel like family reunions mostly. My aunt, who committed suicide around age 50, was much harder, despite her having dealt with mental illness all her life such that it wasn't out of nowhere. My grandfather, who outlived her by three years, was devastated (his wife, my grandmother, not being around as she'd passed away 45 years earlier). When my friend died, I saw his parents quite a few times in the following year. Every single one of those times weighed heavier on my mind than any of those three funerals, despite those having been for family members who I knew quite well. When comparing these early life tragedies to older people passing, the only similarity is death.
• andrewvijay 10y ago
  Absolutely terrifying! "If he left his socks on the floor again today, it is all right." - the only sentence I could relate to. I hate my life.
  • xapata 10y ago
    Why hate the absence of tragedy?
    • andrewvijay 10y ago
      I don't hate the absence of tragedy but the things I do at home that bother other people like this socks example.
• rhyselsmore 10y ago
  As an ex-paramedic this really hits home.
• hopfog 10y ago
  One of my best friends died of an overdose a few years ago. His mother was informed in a horrible way. The police called her and told her that her son had overdosed and was on the way to the hospital. In the middle of the call they all of a sudden say "actually, he's dead!" like it was nothing special. His mother of course screamed out loud, which made the police upset (they said "hey, it's not my fault" or something like that, I don't remember exactly). I normally have great respect for the police but I think this was handled catastrophically. They showed very little sympathy.
• pipio21 10y ago
  You paint taking drugs as something every "kid" does and drugs like something innocuous, cocaine certainly is not. If your daughter took cocaine it has probably a lot to do with your attitude towards drugs as a parent. I volunteer with drugs addicts and drug areas. My work along with other 10 people or so is telling them how terrible drugs are and to offer alternatives(teach them a job, organize and create a community, make them stronger against those that will try to initiate kids, offering model or reference for dysfunctional families...). Sometimes it is really really tough job as you have to remain strong in surreal situations. But in the end it is probably the most rewarding feeling you can experience in life when you see the people you helped to recover and even prosper in life.
  • Symbiote 10y ago
    Most kids and adults use alcohol. Prof. Nutt, one of the leading experts on drug use in the UK, wrote: "MCDA modelling showed that heroin, crack cocaine, and metamfetamine were the most harmful drugs to individuals (part scores 34, 37, and 32, respectively), whereas alcohol, heroin, and crack cocaine were the most harmful to others (46, 21, and 17, respectively). Overall, alcohol was the most harmful drug (overall harm score 72), with heroin (55) and crack cocaine (54) in second and third places." (He was then sacked from his position advising the government, and then all the other scientists resigned from the committee he chaired.) http://dx.doi.org/10.1016/S0140-6736(10)61462-6 http://dx.doi.org/10.1016/S0140-6736(10)61462-6
    • shoo 10y ago
      direct link to full article here (pdf) http://www.ias.org.uk/uploads/pdf/News%20stories/dnutt-lancet-011110.pdf http://www.ias.org.uk/uploads/pdf/News%20stories/dnutt-lance... Drug Total Harm (to individual + to others) Alcohol 72 Heroin 55 Crack cocaine 54 ... Tobacco 26 ... Cannabis 20 ... Ecstasy 9 LSD 7 Buprenorphine 7 Mushrooms 6
      • Al-Khwarizmi 10y ago
• OliverJones 10y ago
  I've worked as a hospital chaplain in a big and well-respected urban teaching hospital. From a teaching point of view, I'm really glad this article by Dr. Rosenberg is available. For two reasons... 1. I wish I had seen it during training. It's spot on in every respect. Dr. Rosenberg's advice to stay with the bereaved, and enter with them into their grief, is good advice. There's no way to do it without simply doing it. 2. It's good that Dr. Rosenberg is teaching doctors to do this work. Often enough in the past, the Saturday night emergency department staff just said "page the chaplain" when they needed to deliver bad news. We chaplains don't mind doing our jobs, but that leaves the frightened family hanging while we scramble to get to the ED and figure out who / what before sitting with the family. And, there's always some practical decision-making that takes time. For example, a Roman Catholic patient needs a Roman Catholic clergy person. So, "page the chaplain" keeps people waiting. If you ever have to do this, do everything you can to avoid physically looking down at the bereaved people. Don't stand over them. Sit on the floor if you must. Some waiting rooms have low coffee tables or side tables. That's a good place to sit. In teaching hospitals, the new residents (fresh-out-of-school doctors) start July 1st every year. And, they staff the ED on weekend nights. So they are getting their first sustained taste of violence, right at the top of the summer heat. They went into medicine to heal people, not to pronounce them. So this is a big shock for them. The ED unit clerk should still page the chaplain, even if the doctor delivers the bad news. This epidemic of violence is awful. For my part, I count strong narcotics with guns, knives, and cars as instruments of that violence. It's horrible that doctors and other hospital folks have to learn how to do this. But they do. It's horrible that families have to hear this bad news. But they do. This article should be posted on the wall of every toilet stall in every high school in the country. Why there? Simply because everybody will see it and have a chance to read it in private.
• known 10y ago
  Really painful.
• fnj 10y ago
  It doesn't have to be a child in the sense of being young. No parent should have to outlive their offspring, especially when they are very close daily. I witnessed the effect on a 90+ year old mother of the sudden unexpected death during sleep (natural causes) of her daughter who was almost 60 but very vibrant. It was crushing. The mother never recovered any of her joy in her own life and only lived another 2 years.