Hektoen International

A Journal of Medical Humanities

The morning ritual

Peter H. Berczeller
Dordogne, France


Years ago, I heard the adage: “When you get up in the morning, and you don’t see your name in the Times obituaries, you’re good for another day.” I was young then, with no understanding of the seriousness beneath this seemingly witty remark. As a medicine resident, I was no stranger to the deaths of patients, or to signing certificates attesting to the dire details of those deaths. Those sanitized versions of the lives of the departed seemed disconnected from my observations of the dying process and the way to permanent general anesthesia. The carnage left behind by futile attempts at resuscitation. The floor would be littered with rhythm strips, as in some dark mirror image of a ticker tape parade. With blood everywhere, the endotracheal tube would stick out of the deceased’s mouth like some giant exclamation mark, as if to emphasize the tragedy that had just taken place. The newly expired patient’s quiet facial features were now frozen in an expression of disdain for the pathetic exertions of the resuscitation team.

Despite my immature lack of understanding of the true meaning of the aphorism, my faithful adherence to reading obituary announcements dates back to the time I first became aware of this saying. There was a bookish quality to my appreciation; the capsule biographies seemed like ultra-short short stories, a momentary insight into the lives of people I did not know. The majority died at a very advanced age, or so it seemed to my younger self. Even the occasional announcement of the death of someone closer to me in years did nothing to diminish my sense of invincibility. I would be joining these unfortunates someday, but that was sure to be a long way off. This supposition was superimposed on a crazy notion of my own immortality, the kind that sends men onto battlefields, convinced that the bullet meant for them is yet to be invented.

My fixation on obituaries has shifted sharply away from the literary; now it has become personal. There is no more taking refuge in the illusion of immortality, which is in ever inverse proportion to the ticking of time. For now, I am assuming the role of the guy who holds the checkered flag at the Indianapolis 500, clocking in the people I have known as they cross the finish line. As I move with trepidation from the headlines and sports news to the obituary page, I wonder what I might encounter scrolling down the day’s death announcements. I am not at all proud of it; the morbid fascination I feel with every name that comes into view. My memory triages whether the individual is familiar to me or not: old patients, colleagues, and friends from college regularly turn up in an ultrafiltrate of the larger group. After the initial shock of recognition, accompanied by a mild thumping in the middle of my chest, there is the inevitable debriefing. First, and almost automatically in my medical mind, are questions about what happened; an attempt at instant clinicopathologic correlation. The regrets pour in next. In regard to friends: how and why did we lose touch? Was there some long-forgotten dispute or a lack of interest on one or both sides? With former patients, I shift to another gear. Although it sounds improbable, I still retain salient points of their major ailments in some recess of my long-term memory. Did one or another of those maladies finally do them in? Or—I have always been guilt prone—did I miss something when they were still under my care that, years after my retirement, finally gave them a sendoff on this page? It is too late now. My qualms are like so many petals strewn into the void before the earth is shoveled into place.

I mention these ruminations because I find myself in a particular quandary these days. Should I—or should I not—try to contact an old enemy-turned-friend from way back? It is a question which, under normal circumstances, would deserve a simple answer. No such luck here.

In the 1950’s, while on my rotating internship at a Manhattan teaching hospital, I fell in love with Bobbie, a student nurse at the same institution. Prince Valiant hairdo, shiny green-blue eyes, stylish legs. She was slightly older, with intimations of a mysterious past—a brief marriage, a stint as a parachuting instructor. I agonized again and again about the possible practical outcome of my feelings for her. She had often enough expressed the desire to settle down and have children, while I much preferred the status quo of our intense affair. I just was not ready to be a husband and father; not yet anyway. My mind was soon made up for me by Luis, a Mexican-Hungarian urology resident—his temperament a mix of chili peppers and smoked paprika—who swooped down on Bobbie. The whole hospital was soon witness to my failure as a follow-through lover. My embarrassment compounded when I met the lucky bridegroom in the elevator of the house staff quarters on his way to marry the girl I still loved. The atmosphere in the small cabin was glacial as we descended, very slowly it seemed to me, to the ground floor. Needless to say, I had not received an invitation to witness the ceremonial breaking of the glass. I pummeled myself with regrets.

Bobbie and Luis moved to the West Coast and divorced a few years later. Through mutual friends, I heard that she had died not long after that. At some time in the 1990’s, I got an out-of-the-blue phone call from Luis; he was in New York and wanted to say hello. When two men are in love with the same woman, the asymmetry opens up two possibilities. Either the protagonists turn into mortal enemies, or a strong bond is forged between them. By this time, the palpable animosity in the elevator was ancient news, and the latter eventuality took over seamlessly as soon as we met again. Our joint loving memory of Bobbie when she was at her best won the day, despite the rupture of their marriage and my memory of her wounding rejection. We promised to stay in close touch, something we held onto until several years ago, when there was a brusque news blackout on Luis’ side.

I often wonder what has happened to him. Is he dead, and his current wife sees no reason to notify me, since she is unaware of our late-blooming friendship? Has dementia become the order of the day, so that our complicated past history has flown away with the fairies? Or, in some age-induced paroxysm of crankiness, does he terminally resent what Bobbie and I shared before he took matters into his own hands and spirited her away?

Why don’t I try to dispel this disconcerting uncertainty? A simple phone call or email could do the trick. I resolve to do it again and again, but when I wake up in my home in France, it is already past midnight in Mexico. Maybe it is just as well. What if there is no answer on the other end? I am not prepared for a terse impersonal notice in reply to my email, stating that the account in question is closed.

This all sounds reasonable—and is also 100% self-protective, misleading hooey. I know exactly why I don’t try to find out what happened to Luis: I don’t want to know. I need Luis to be alive, even if it is only in my head. After all these years, I still cannot bear the thought of the two of them—Bobbie and Luis—taking off together and leaving me in their wake.




PETER H.  BERCZELLER, MD, was born in Vienna, Austria in 1931. He attended The Chicago Medical School and received his MD there in 1956. He was a practicing internist from 1960 to 1992, at which time retired from private practice. He was also on the Attending Staff at New York University Medical Center and Clinical Professor of Medicine at New York University School of Medicine for many years. In addition to multiple contributions to the medical literature, he is the author of several books dealing with medicine and one novel. His 1994 book, “Doctors and Patients: What We Feel About You” has just been released as a trade paperback by Simon and Schuster. He now lives in the Dordogne, in France.


Summer 2018  |  Sections  |  End of Life

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.