“She was 1 of 11 children, so she knew a lot about how to take care of the home and the children,” said Dr. Moody, professor and chairman of the department of internal medicine at the University of Texas Health Science Center at Houston.
Maja spent the final 4 years of her life on a feeding tube at the family's second home in Sandy, Utah, where a team of three nurses provided her with around-the-clock care. Dr. Moody continued to commute to his full-time surgery post in Houston.
“People kept wondering if I should be expending so much energy and working so hard because they couldn't identify [with] the fact that she was happy,” he said. “She was happy to be alive. We had talked about this end-of-life scenario at some length before. The only thing she didn't want to do was have heroic care that wasn't going to be of any benefit.”
That time came on December 26, 2004, when Maja died in Dr. Moody's arms at a nearby hospital, with their children present.
All the while, Dr. Moody did not seek support for his bereavement, but shortly after Maja's death, he did discuss end-of-life care with a group during a retreat in Sundance, Utah. “It was cathartic to be able to speak publicly about her life and her death,” he said. “She had 4 years of dying, or 10 years, really. I had to come to grips with this over a period of time. It wasn't a tragic thing that was devastating to me. It was a natural thing in life. We had wonderful years together. She had a fantastic life.”
The most important thing for him was returning to work. “It helps, because [then] you don't dwell on things,” he said. “At least, that was my style. I had to prepare myself over a 10-year period by keeping the routine. I kept working. I'm 78 years old, and I'm still full time.”
Dr. Marco Coppola and his late wife, Dr. Margaret J. Karnes, on the day they learned she had inflammatory carcinoma. Courtesy Dr. Marco Coppola
A Brush With Death and Grief Revisited
Three years ago, Mary Jo Rapini was lifting weights at the gym when she burst a cerebral aneurysm and collapsed to the floor.
“They couldn't find the aneurysm when they first did the angiogram because my head was so full of blood,” recalled Ms. Rapini, a licensed psychotherapist in Houston who is married to a dermatologist. “I was in the ICU for a couple days. On the third day in the ICU, I got really sick and was probably 24–36 hours away from death. That's when I had a near-death experience. Basically, God told me I couldn't stay and had to return to earth. It was beautiful, wherever I was. I protested. I had a lot of grief coming back.”
The brush with death shook her husband, Dr. Ronald Rapini, because as a dermatologist, “he knew nothing about cerebral aneurysms, yet since he was a physician, so many times the neurosurgeons did not explain things well to him because they assumed he [already] knew,” Ms. Rapini explained.
She added that physicians “are so used to being in control that when they lose a spouse or a spouse is sick, they realize they're not in control at all,” she explained. “So they go back to what they know. They go over forms. They do research on the Internet. They call their other colleagues and ask 'do you know anything about this? Can you help me with this?' They understand medicine, but they might not understand what their spouse is dying from.”
She recommends that physicians who lose a spouse “take care of themselves, even though they are not used to doing that.” Physicians “derive more satisfaction from taking care of other people,” she said. “Grief is not something you can delve into … and get over. Grief is something you have to go through, no matter who you are.”
She offered the following tips:
▸ Maintain social ties. “Usually if a spouse dies, the physicians work so much that they allow little time for their social life,” Ms. Rapini said. “The wife kind of brings the social people in. So if she's the one that dies, many times the physician is alone and he's not comfortable without his spouse. You may not see this if the female physician loses her spouse. Women seem to socially network more, and this very same network is very supportive in the event [of] a crisis or death. I would encourage [physicians who lose spouses] to go to dinners when they're invited out, to keep those social connections with their friends that they had together.”