Journal of Palliative Medicine

It could never go on forever.

Never does.

Not life. Not happiness. Not this. Not any one friendship.

Me?

I’m thinking this, only days after watching Bruce Springsteen sing elegiacally in Kansas City of his own city — by intimation, by extension, of his friendship with the dead Clarence Clemons — of a city, their city back then, of Clarence, lost now, of their friendship, their love, this, theirs, now, a city of ruins.

The Boss then slow-stepping sideways into lights lighting the far corner of the stage that had so long been the Big Man’s.

“Now, there’s tears on the pillow,” Bruce, so haunted himself, went on to sing, “…you took my heart when you left/ without your sweet kiss/ my soul is lost, my friend.”

And me, the palliative doc, watching, listening, feeling, hearing in Springsteen’s voice, seeing in his shadow, itself shadowing a cone of light, the ghost of one friendship past, the ghosts of life itself.

Bruce, all at once, without the friend of his life.

Me, counting the loss of so many lives in my life.

My mother. My father.

Just this week a much-loved uncle. And before, aunts, uncles, grandparents. Friends, too. And only this past weekend, yet another patient.

Call him Jim.

Just 50.

Wife, three kids, the youngest, a daughter, only a girl, herself just 11.

Beautiful farm, our outpatient nurse-practitioner had told me.

A house Jim had himself built.

His whole life, for all he knew, for all any of us ever know, ahead of him.

Only then, a year ago, at another time of thanks, to find himself ill, to find himself losing weight. Only weeks later, only days after a new year suddenly made unhappy, a pathologist telling the tale: cancer, and mere months later, by CT, cancer…cancer everywhere.

Jim’s father had died at 44.

Jim himself explaining that he, young then, had felt robbed by his dad’s death, only now, tears flowing, to have death thieve from his own children their chance to have their own dad there.

His college-aged daughter all too soon graduating without him at graduation. A son, in high school, no dad to see him through high school to college, to marriage, to grandchildren. That little girl, herself with her whole life ahead of her, only knowing her dad this long, these few 11 years.

“My dad is going to die,” that little girl had told our social worker some few weeks ago.

My own brother was himself 11 when our mother died of breast cancer, me then all but 30.

To this day, I cannot know what Patrick experienced then at 11.

What I remember, these 31 years later, is Patrick making our mom laugh, often over nothing, she so sick, he coming in from school, his smile, whatever words, her face all at once alit, until one day, one June, the light that had been our mother went out.

And after that, Karen and I making Patrick, my brother, our son.

And now little Maria, her dad gone.

Her big sister away at college. Her older brother coping as best he himself can. Their mom, the widow she could never have imagined herself being, certainly not now, never this young.

And me, all these years after my own mother’s death, often in those years contemplating what that had meant to Patrick back then, now thinking the same, wondering what thoughts now darken Maria’s thoughts these few days after her dad’s death.

And what would I, were I with Maria, tell her tonight…

Tell her that her life might be still be life; may yet be the life her dad would have wished for her; that some day, not any day soon, she may yet get through a day without thinking of her dad, of this, her loss…

Maria, only then, like me, these 31 years after I lost my mother, 18 after saying goodbye to my father, remembering…

Remembering what was.

All that love suddenly lost. Maria knowing, in the end, what I already know, that there is no end to this, this grief, even when life itself ends.

Back at Jim’s farm, his wife, their children, this week look out to the evening trees.

And me here this evening, not so many miles from that farm, wishing that family sweet veils of mercy, those of which Bruce sang in that same song, those veils drifting through those same evening trees. Bruce’s next question, as for me once, for my brother, too, for Jim’s wife, for his children, the question that is now, has always been…

“Now, tell me how do I begin again?”