What the Funeral (Re)taught Me

In the liturgical tradition of the Episcopal church, a funeral is an Easter service. It finds all its meaning in the resurrection. It is characterized by joy. This joy does not make the human grief we feel unChristian or wrong.

None of us lives to himself, and no man dies to himself.

“For everything there is a season, and a time for every matter under heaven: a time to be born, and a time to die; a time to plant, and a time to pluck up what is planted; a time to kill, and a time to heal; a time to break down, and a time to build up; a time to weep, and a time to laugh; a time to mourn, and a time to dance.” Ecclesiastes 3: 1-4

“Help us, we pray, in the midst of things we cannot understand, to believe and trust in the communion of saints, the forgiveness of sins, and the resurrection to life everlasting.”

“Dust thou art, and unto dust shalt thou return.”

Rest In Peace, Reynolds Gracy Jarvis, M.D.

Death of a Mentor

My friend, teacher and mentor Reynolds Jarvis MD died on May 21, 2019, after a long battle with amyotrophic lateral sclerosis, or Lou Gherig’s Disease.

Reynolds was a man who came into my life in that period of time between 1983 and 1987 when I was learning how to be a doctor, and more specifically, a psychiatrist. Yes, I had earned my MD degree in 1983, and I was licensed as a physician, but I had not clue one what I was doing. We were all struggling back then, all the folks in my small residency class at the Medical College of Georgia in Augusta, Georgia, to find our sea legs on the ocean of pathology that confronted us daily. Reynolds was one of the men and women who was entrusted to teach us how to be knowledgeable, compassionate, competent doctors.

He was one of those rare physicians who was proficient and comfortable with one foot in the world of mental illness and the other in the world of internal medicine. He was at ease when diagnosing cogestive heart failure, pancreatic disease, hypertension, as well as depression, bipolar disorder, and schizophrenia. If a patient had more than one illness, and one of each type, then bring it on. He would help us learn how to tease apart the pieces of history that we needed to make accurate and relevent diagnoses.

He liked to tell stories and especially liked to put things in the context of what real people needed and wanted, and how they went about seeking the goods and services that they needed to make their lives better. These concepts had been formulated and taught by another of our mutual mentors, Dr. E. J McCranie, several years before. We all loved to stand around a keg of beer in those heady days, waxing poetic and scientific about the ins and outs of human need and psychiatric pathology.

Reynolds would rotate as attending physician on both internal medicine services and psychiatric services. Rounding with him, talking over patient presentations with him, was a treat. He had the respect of both departments, and that was not lost on his charges.

Another physician friend of mine made me aware of his illness one day at church. I had not known that Reynolds had been ill, as I had not seen him in many years. He told me about his diagnosis, which room he was in at the hospital, and said that he had been by to visit. I might want to stop by to visit too, he offered. I thought about this, knowing that it would be the right thing to do, and promised myself that I would consider it.

I never went to visit my old friend and mentor.

I feel sad about his death, but now I feel even more guilty that I did not go to tell him thank you before he died. Why did I not make the effort to go to the hospital to say hello?

There are many reasons, some of which are merely excuses. I can tell myself that. It doesn’t help, but I tell myself that anyway. I remember Reynolds being large and in charge, in that soft, confident, smooth talking way that only he could. I remember him being smart, so much smarter than me, and thinking that one day it would be great if I could be half as proficient at my craft as he was at his. I remember him being one of my teachers, only seven years ahead of me in his graduation from medical school, but seemingly light years ahead of me in experience and confidence. I was so angry inside when I heard that ALS was going to cut his life short, in that cruel way that any progressive neurological disease does, robbing one of all dignity at the end, and not respecting race, color, creed, class, or MD after a name as it ruins another life.

I did not want to see him that way, could not see him that way. I did not want to confront his death, for in doing so, in saying goodbye to my teacher, I would now have to realize that I am closer to confronting my own. Each loss we bear brings us closer to our own loss of this life, and I was not in a place to do that. I feel ashamed, but it is the truth as I feel it right now. Diseases like ALS take away all our control, and I could not bear to see my old friend, once so easy going and confident, in that state. Forgive me, Reynolds.

His funeral is on Saturday at our church. I will be able to attend, just before I take the short drive to Aiken to work a long emergency room telepsychiatry shift until midnight that night. I will go to pay my respects, as I should.

Do we really lose people, their ideas, their skills, their emotional imprint on this world when they die? Do we really? Or do we carry part of them with us, always, imbedded in us just as surely and firmly as any of our own DNA?

I choose to believe that when they are gone physically that we keep some of them with us until we are gone, and by that time we have passed some of that wisdom and wit and energy and intelligence and competence along to someone else that we care about very much. As the wonderful animated movie Coco taught us, as long as someone has a picture of us, thinks about us, and holds us dear, we never really die. It’s only when there is not a soul who remembers us that we truly pass away.

Dr. Jarvis, I will go to your funeral on Saturday. I will smile when I think about the things you taught me that I use to this day. I will leave your funeral, go to my office and see people in the emergency rooms of South Carolina who are in need. And I will be very, very glad that our paths crossed as you taught me what it means to be a physician.

Rest in peace and rise in glory, friend.

Amen.

(Image of Dr. Jarvis via Platt’s Funeral Home obituary in the Augusta Chronicle)

Thoughts on Death, Part One

I posted yesterday about a chance meeting with an old acquaintance. With a simple question, he was able to make me think about my own state of affairs today, and to have the wonderful conscious thought that yes, indeed, I am happy.

Today, I turn my thoughts to death, not because I am depressed, but because I recently lost a medical colleague to a sudden heart attack, just days after he had left our employ and started a new job in the upstate area of South Carolina. There are certain thoughts that come up in one’s mind anytime someone dies. When a colleague dies, especially a colleague you have been related to in a supervisory context, these thoughts are varied, multi-layered, and complex.

Dr. B was sixty nine years old, eleven years my senior. It is always hard to supervise an employee who is older than you, but it happens more and more frequently in today’s workforce, where the average age of employees has risen across the board. Specific incidents sometimes arise that must be dealt with directly, and supervisors with their own authority issues may have a difficult time dealing directly with these issues. Also, as one ages, one tends to fall back on “the way things have always been” or “the way we have always done it”, and this may lead to conflict in the workplace when practice trends, productivity expectations, and operational use of new theories and practices are foisted upon all employees, seasoned and new.

In medicine, as in many other fields, we are taught to be lifelong learners, productive professionals, self starters, and industrious workers. We are taught in essence to tow the line, to be like everyone else, and to “close ranks” when adversity strikes us as a group. Like the “Thin Blue Line“, medical professionals look after each other, support each other, and have each others’ back, even as they try to fight illness and foster the health of all members of society.

Now, this does not mean that we as medical professionals always agree or always do things exactly the same way. We are trained in similar ways, some of us at the same programs by the same mentors and professors, but we develop our own practice styles as we age and as we become more senior in the profession. Best practices are guidelines that are generally regarded as the standard of care in most medical circles today, but there is plenty of wiggle room in medicine for the “art of medicine” to still shine through. Personally, I am glad for that.

All this to say, I guess, that we must strive to respect those who disagree with us, or who we disagree with. Especially in a professional group such as mine, it is imperative that we respect each other, have open dialogues when disagreements occur, and that we constantly try to improve the practice of medicine in general and our own take on it in particular. This is paramount in times of stress, such as the current period in medicine when electronic medical records, reimbursement, documentation and maintenance of certification grab more headlines that the latest cures for some obscure disease.

Death, and what it takes away from us, also makes us rethink what could have been. Did I really listen? Did I strive to understand the pressures from the other side, the other perspective? Did I give that situation a fair shake, or did I simply blindly impose my own value system on it and make a decision that was rigid and not completely informed? Hindsight is always 20-20, isn’t it? Death takes away our ability to rethink, reprocess, and correct course. Death is nothing if not final.

I wil be attending the visitation for my colleague on Thursday evening. Somehow, the little things that mattered so much two weeks ago, the scheduling issues and the specific patient problems and the interpersonal stresses and all the rest, do not seem so important now. Whether they were imposed on me from above and I was simply an agent of change, passing down information or rules to my supervisees, or things that came from inside me, doesn’t really matter now.

What does matter is that a colleague has finished his life’s work, albeit much sooner than he anticipated. He has listened, heard, and acted on the things that he could change for his patients, and he has done ¬†his best. His toils are done.

He has taught me, like everyone I have ever worked with has, some important lessons. I will be a wiser man, and a better one, if I heed them and use them in whatever time I have left to live my life.

Rest in peace, friend.

 

Charles “Chuck” Baber III

August 31, 1946-December 13, 2015