And Death Shall Have No Dominion

“Though lovers be lost, love shall not;

And death shall have no dominion.”

Dylan Thomas, 1933

The Pasatiempo magazine comes every Friday with the local newspaper’s end of the week edition—the New Mexican’s “Weekly Magazine of Arts, Entertainment and Culture.”  Needless to say, with two yearling giant sized puppies hell bent on destroying my house, I don’t get out much.  But I do like to browse the magazine.  What caught my attention today was not the local events profiled inside, but rather the advertisement on the back cover:  “An Open Letter to the Citizens of New Mexico.”  The full page ad detailed a place called Orion’s Peace Camp and Learning Center.  As it turns out, Orion Strong was a boy who attended the Peace Camp in 2005 as a seven year old.  In 2013, at his eighth grade graduation, Orion received an award presented to the student who best exemplified the concept of selfless service and for his commitment to being drug and alcohol free.  On November 10th, 2014, the ad stated that “Orion earned his angel wings after a 17 month battle with leukemia. Before he transitioned, Orion asked those who want to honor and remember him to do something to uplift the community.”  Earned his angel wings?  Transitioned?  Why can’t we just say “He died.”?   Because, as the poet Rilke said, “Der Tod ist gross.”   Death is huge.  And when it happens to a child, it is unthinkable and unmentionable.

Tuesday, October 25th would have been my nephew’s 21st birthday.  He died on August 30th while away at college, about to begin his junior year.   He was articulate, intelligent, handsome and beloved by his classmates.  To celebrate his birthday, his friends and peers gathered at a harvested wheat field near the college in eastern Washington state.  In the photographs, the wheat chaff is yellowed and lifeless against the ground and there is a roiling gray sky.  There is a storm coming—one can feel it.  His friends hold balloons, each emblazoned with a message for their lost friend. The barometric pressure rises, creating an intense feeling of suffocation. And then the balloons are gone, risen to the ether while his friends remain behind to grieve.  There is a strange light in the horizon.  It is dusk, but it seems like dawn.  And death shall have no dominion.

I am sure that two years later, Orion Strong’s family is still grieving.  And I am certain that we will be grieving the death of my nephew in every year to come as summer gives way to fall, as the leaves turn blazing colors and the nights grow cold.  There is no making lemonade out of lemons when it comes to the death of a child, a brother, a grandchild, a nephew.  We each have to do what we can—my sister will establish a scholarship in her son’s name at his college; I will go back to work to fight cancer and I will make a donation to Orion’s Peace Camp.  And I hope that my nephew’s friends and classmates will remember him and seek help if they are struggling, and lend a hand to their peers that need guidance, and that each and every one of us will resolve to be a little kinder and a little more understanding.  Death is real; death is huge, death is not a euphemism.  But let us all strive so that in the end, no matter how or when it comes: “Death shall have no dominion.”

In Memoriam–Dr. Michael Davidson

In 1994, I was working at my first radiation oncology job in San Diego at Grossmont Hospital when I came into work to hear disturbing news.  One of my colleagues in medical oncology, a compassionate man known for his gentle nature, had stayed late at the Cancer Center the evening before to finish up paperwork.  With his back to his ever open door, he sat at his desk never once considering that he was in danger.  A disgruntled relative of a former patient surprised him from behind, and beat him viciously over the head and body causing broken bones and contusions, and leaving him for dead.  He managed to call for help, and he survived after spending two weeks in the hospital.  He returned to his practice of treating cancer patients after a long convalescence—after all, it was his calling in life.  He died many years later, suddenly at age 69.  I do not know if that beating years earlier contributed to his early death but the knowledge of it certainly changed my life.  I worked late, and was alone in many offices at night after that, but I remained cautious and vigilant about security, never again taking safety for granted.

Yesterday I got a hasty text message from my daughter, who is a second year internal medicine resident at Boston’s Beth Israel Deaconess Medical Center.  She told me that a doctor at Brigham and Women’s Hospital, a fellow Harvard teaching hospital, had been shot at work and that the hospital was on lock down.  She didn’t know how much was in the news yet, but wanted to let me know since I had trained and worked at these hospitals.  I was as shocked as she was, but I should not have been.  The doctor, Michael Davidson, was a highly respected young cardiovascular surgeon—a rising star in his career, and a husband with three children at home.  The gunman, having sought out Dr. Davidson, fired two shots at close range before retreating to an exam room and taking his own life.  Dr. Davidson was given immediate medical attention by his colleagues at his own hospital, one of the top trauma centers in Boston.  He died of his injuries late last night.  As it turns out, the shooter, Stephen Pasceri, had no history of violence and his gun was licensed.  But he did have a history of dissatisfaction with the “medical system” and sadly his mother had been a patient of Dr. Davidson’s, and had passed away two months ago.  Not much has been said in the news about her, but such is the nature of cardiovascular surgery—these doctors do not operate on healthy patients and not every outcome is successful.

When I visited the Hope Institute in Jamaica in 2013, I saw many patients dying of cancer, without the benefits of affordable chemotherapy, state of the art radiation therapy and even without a readily available supply of morphine.  But I did not see anger, in the patients or their relatives, who were cared for under the loving guidance of Dr. Dingle Spence.   Here in America, quite the opposite is true: we have come to believe that every disease is curable, that every outcome should be positive, and that death, in the words of Dylan Thomas, shall have no dominion.  Most of us, however do not take to the wards fully armed, looking for our doctors. Today I am in despair for his wife, for his children, for the surgical residents he would have taught, and for the thousands of patients that Dr. Davidson could have helped if his life had not been taken.

When we graduate from medical school, we take the Hippocratic Oath, which in the modern version not only exhorts us to heal the sick but to exhibit warmth, sympathy and understanding.  Let our patients and their families extend those same traits to us as we complete our daily rounds.  Let our clinics and hospitals be places of healing, and not of killing.  Please, please let us do our jobs.

Addendum January 22, 2015.  This was submitted by a colleague in the Comments section but I want to bring it forward to the actual page.  Please take the time to read and consider signing.

Dear colleagues,

The violent death in Boston of Dr. Michael J. Davidson, an inspiring cardiac surgeon who devoted his career to saving lives and improving the quality of life of every patient he cared for, is a senseless and horrible tragedy.

There was an incident in the past where a patient at a VA hospital made a threat to shoot a physician.

VA physicians are federal employees. Federal employees have enhanced legal protection against violence. The threat of violence toward a federal employee by itself is illegal. Police officers were able to conduct an investigation and speak with the patient. Once the patient understood that the threats could lead to prison, the volatile situation was defused.

Laws protecting federal employees against violence provide an additional tool to help direct an individual away from violence. Unfortunately, this protection does not extend universally to all healthcare providers.

The White House has a “crowd-sourcing” system where the executive office reviews proposals with at least 100,000 signatures obtained within a 30 day period.

http://wh.gov/i220E asks that the legal protections against violence currently provided to federal employees be extended to all healthcare providers.

While no law reduces risks to zero, our effort would be well worth the energy if it could prevent even one senseless death.

Please take a moment to sign this petition, and consider spreading the word. Everyone can sign this petition including your friends and family.

Thanks.