Thread by @TheRealDoctorT

“Have you ever been close to tragedy?
Or been close to folks who have?

Have you ever felt a pain so powerful,
so heavy, you collapse?”

~The Mighty Mighty Bosstones, “The Impression That I Get.”

It’s late Fall, in the vast grasslands of the American West... 1/

A tiny turquoise-blue Mountain Bluebird lands on a branch. Its considered to be one of the most beautiful birds of the land.

The photographer holds her breath. She is motionless, even though she knows the bird can’t see her from so far away.

She brings it into focus, and... 2/

I’m sitting in a special room. It’s just outside the intensive care unit, adjacent to the waiting room.

Every ICU usually has one. Most ERs too.

The sign on the door says “Consultation Room” but that’s only half the truth.

This is where lives are often changed forever. 3/

I have just had a conversation with a grieving family. The room is now empty, except for me and the Palliative Care physician.

Well, I say it’s empty, but grief leaves behind a palpable weight. A lingering reminder of the gravity of broken hearts.

Echoes of dreams undone. 4/

The Palliative Care doc is named Ben. He is a gifted clinician, and thrives in his difficult role. He is somewhat baby-faced, appearing years younger than he really is.

His smile is warm, and natural. He exudes empathy.

When he nods in understanding, you believe him. 5/

The two of us sit in silence for a few moments, in the “consultation room.”

My gaze is drawn to the pictures on the walls. Someone must like birds. One wall is covered in framed photos of them.

Brilliantly colored, they seem ready to take flight.

I envy their freedom. 6/

“One down, five to go.” Ben breaks the silence with a sigh.

My eyebrows go up. “You have FIVE more family meetings today?”

He nods, taking off his glasses and rubbing his eyes. It’s one of the few times I’ve seen him look weary.

“How do you do it Ben?” I want to know. 7/

He smiles, and just like that his moment of vulnerability has passed.

“Well, Sayed, it’s like any other difficult task I suppose. I studied, I practiced, and I’ve had a LOT of these conversations. I have a system now, an approach that seems to work pretty well.”

He shrugs. 8/

The silence between us grows for a moment, before he speaks again.

“It’s honestly the little everyday things that stay with me. One patient once told me his biggest regret was he wouldn’t ever get to walk his dog again. I remember that and think about it... a lot actually.” 9/

Listening, I nod, and then probe a little more. “Does it wear on you? How do you do this without hurting?”

He is about to answer, when he pauses for a moment.

Abruptly, he changes the subject, “You see those birds on the wall? Which one’s your favorite?”

I look up. 10/

My favorite color has always been blue. One of the birds is a beautiful turquoise-blue. It seems to be looking right at the camera, wings about to unfurl so it can take to the sky.

I point at it. “That one.”

Ben squints at the frame. “Mountain Bluebird. Nice.” 11/

As he gets to his feet, Ben gestures at a photo of a bright green bird. “I like that one. It’s a ... hmm, Green-Breasted Mango.”

I burst out laughing. “You’re joking.”

He gestures. “See for yourself!”

Sure enough, it’s a Green-Breasted Mango.

A thought occurs to me. 12/

How many people have sat in this room and looked up at those bird photos while devastatingly powerful feelings cascade through them.

How many people have had a detached part of their minds focus on the bright colors to numb the pain?

Ben seems to sense my wandering mind. 13/

He turns to me as he opens the door to leave the room.

“You asked me how I do this without hurting. The secret isn’t in feeling nothing. It’s just accepting what you feel. It can hurt, sometimes worse than others. And I accept it, whatever it is. I accept it.”

He smiles. 14/

I smile in return, getting to my feet and following him out the door. I feel a strange warmth course through me, snaking down my spine and flooding outwards.

As if I’ve learned some cosmic truth.

“Accept it.”

I take one last look back at the photos on the wall, then leave. 15/

The Mountain Bluebird puffs up its chest as a cool breeze ruffles its feathers.

The photographer watches it through her lens and smiles as she snaps her photo.

Beautiful.

Suddenly it takes to the sky, flying off as if startled by the burden of all the grief it will never know.

(Two points of clarification. 1. The “consultation room” isn’t only for bad news, but any sort of discussion or private space requirement. Some conversations are happy. 2. The birds below are the ones from the thread - guess which is which... Photos from the Audubon Society.)