The butterfly

Thank you Dr. McCutcheon for sharing. I continue to process the loss and grief of death in my family, and in writing my story I also thought of the butterfly: the fluttering eyelids of his body whose soul was slipping away, and a paper cutout of the insect pinned near the bedside when he finally left. I believe that as physicians, we both witness immense suffering and are assigned the expectation -- either by others or by ourselves -- to alleviate that suffering. As such, our own experience of grief can be particularly painful and enduring. I hope that Dr. McCutcheon and those that relate to her story find the strength to heal with the fact that you grieve because you care -- what makes us deeply human. Perhaps we can see the butterfly and its metamorphosis as a symbol of transformation, which I think grief can ultimately lead to.

Thanks for sharing this. A beautiful story that many can relate to but not articulate as well as you have.
Hugs from us wounded healers everywhere
Jim Stephenson

Dr. McCutcheon writes about a scenario we have all faced as physicians. Either a delay or missed diagnosis that haunted us, or the impotence one feels as your patient is devoured by an illness. She has captured the humanity of her patient, but so much of her and her family's grace as well.

McCutcheon brings up important themes of non-abandonment and the importance of witnessing our patients' journey. Modern medicine has diminished these tasks as we seek to diagnose and fix things. McCutcheon demonstrates that continuing to be engaged in out patients' lives, not matter how progressive and fatal their illness is, is our greatest duty and for many, our greatest service to them.

Barnhill writes, "these efforts at understanding...provide an important mirroring experience for the patient who feels like she is falling apart, the creation of a dynamic life narrative can allow the dying patient to regain a sense of cohesion during a time of disintegration...maintain a respectful alliance with someone for whom the typical response is abandonment".

When our first response is to flee, often the best response is to step forward and embrace our discomfort. Patients are remarkably resilient and forgiving - more than we often are for ourselves.

Thanks for sharing this story. You could not have prevented her illness, and several weeks of delay in diagnosis probably made no difference in outcome. She forgave you any shortcomings, and you should forgive yourself. Your sticking with her and supporting her through to the end is being a true physician. Healing is not always curing. Peace be with you.

this is very very well written and beautifully captures the essence of what many of us have been through. Well Done. E Stahlbrand MD