Correspondence published in NEJM

N Engl J Med. 2001; 345:374-375, Aug 2, 2001
Copyright 2002 Massachusetts Medical Society

The Sounding Board by Bedell et al. on the doctor's letter of condolence (April 12 issue)1 was distressing to read. My wife of 40 years died at a prestigious teaching hospital. For nearly four years she had struggled with carcinoma of the fallopian tube. There were 26 hospital admissions for surgery, chemotherapy, or emergency rehydration. When standard approaches ultimately failed, she managed, largely through her own research, to become enrolled at another distinguished hospital in a high-risk experimental protocol: high-dose chemotherapy followed by transplantation of autologous bone marrow. But the regimen turned out to be lethal. She died after three days in the emergency cardiac unit.

Neither the hospital management nor the attending physician or anyone from the house staff ever troubled to write or telephone to express sympathy or offer an account of what had gone so wrong those last disastrous days. The effect of that bizarre silence was to make me wonder whether some monumental mistake might have been made in preparing the dose that was to end her life.

The next of kin are entitled to some expression of sympathy or concern, even when it is not deeply felt. Those close to the deceased can only be baffled, resentful, or suspicious when no condolences are expressed.


Arnold Lerner

References

1. Bedell SE, Cadenhead K, Graboys TB. The doctor's letter of condolence. N Engl J Med 2001;344:1162-1164.

Last update: 7/24/02; 11:53:33 PM.