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Not a book about "saving lives" - An emergency medical doctor who only writes about dying – is he allowed to do that? Why not? Many "life savers", medical doctors, nurses, in short: people, who are regularly confronted with other peoples' death, have their own way of dealing with the topic of "death and dying". Whilst death is often not allowed to have a place in everyday life in today's society, these people are used to talking about it openly. For "bystanders" this often seems strange, possibly even disrespectful or irreverent. But is that the case? Are we like that? This question is the basic motif of "Death in my life": Autobiographically, this book follows the author's journey through his development, provides insight into his emotional world and the constant changes in his attitude towards life and death. Between analysis and his own processing strategy, Tom Werde invites the readers to take part in his "life with death" and to question themselves and their own norms and values.
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Veröffentlichungsjahr: 2024
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Death in my life
…what makes us be the way we are
Tom Werde
Imprint
text:© copyright by Tom Werdecover design:© copyright by Tom Werde
photography:© copyright by Jan Evertspublished by:Dr. Thomas D. Werxhausen
Malteserstr. 6850859 Köln
translation by:the author himself, Tom Werde
printed by:epubli, ein Service der
neopubli GmbH, Berlin
Printed in Germany
Dedicated to my beloved parents.
Cologne in 2017
Inhaltsverzeichnis
Preamble to the English edition (2024)
Preamble
Introduction
Chapter I: My Grandparents
Chapter II: First Times
Chapter III: „Being allowed to leave“
Chapter IV: My Parents
Chapter V: Three Times Death, Three Different Emotions
Chapter VI: Proximity
Chapter VII: The Year Of The Children
Chapter VIII: Here And Now – God And The World
Chapter IX: „I Could Not Do That“ –„You Are So Extreme“
Thanks to
Preamble to the English edition (2024)
After having completed the original German version of “Death in my life” and having published it in 2017, l got “Being mortal” by Atul Gawande as a present by Christine, a friend of mine and a fellow medical doctor. I enjoyed reading it a lot and experienced sequences of several moods throughout the lecture – from sadness and grief, compassion and disappointment to joy, relief and sheer maniac motivation to provide more and better care to elderly and especially incurably ill people.
I believe to have recognized some parallels in
both Atul Gawande's view of life and death and mine.
So the actual main motivation to translate and publish “Death in my life” in English language was the opportunity to give it to him as a kind of a remote thank you for his piece of art, which managed to raise these manifold emotions in me.
In order to put some of the following stories into context especially for medical professional readers, I would like to forward some basic information about German emergency medical service: In addition to paramedic-manned ambulance-cars (as known in several countries), emergency medical doctors are taken to the scene of emergency by so-called emergency medical vehicles (in German: NotarztEinsatzFahrzeug - “NEF”) and are accompanied by an additional paramedic.
Preamble
I love my job. After more than eleven years of being a medical doctor and roundabout six years of further traumatologic-surgical education I’ve been working as an emergency physician for five years in full time occupation. I am certain that I don‘t want to do any other job.
Besides the fact that I enjoy the luck of doing my work together with great people (most of them obviously love their job as much as I do and they do high-end emergency medicine in an excellent level), it is the nature of my work that satisfies me the most.
The immediacy of the action, the direct patient contact – which is, different from the work at the hospital, concentrated on one patient at a time – and the unplannable, spontaneous diversity of events during each and every shift makes my job unique.
Like no other occupation it gives me the opportunity of taking care of my patients on my own responsibility. I have got the chance to experience the success of my action immediately and most quickly.
The immediate interaction with each and every one of my patients always gives me (to a different extent) insight into their personal situation and lets me participate in the stories behind their fate.
Of course, I cannot identify with every single person I meet.
Most obviously, no one can ever manage to feel empathy with each fate and event crossing his ways during emergency medical service.
By far most of our cases may be considered as „routine business“, which we can manage by our experience, good standards and the necessary amount of engagement without having to get into the life of the people we treat too far.
Anyway, time and again, there are operations, situations and events that come closer to us than the „daily business“. Personal fate that touches us and bothers us, sometimes far beyond the work itself. Experience and situations, which make us question our own life and our personal attitude towards it and awareness of life in general.
This may especially concern encounters and dealing with death and dying. Every individual has got his or her own idea of it and figures out a personal way of dealing with this uneasy topic. The most common way to do so may probably be the attempt to repress death as far as possible out of one’s awareness – for the simple reason that otherwise we are forced to face the fact of our own mortality – not an easy subject for a cosy chat at the Sunday coffee or at least this might be the common idea.
I think it different. My job does not offer me the choice, whether I want to deal with death or not – it simply is a part of it.
For that reason, everyone who is involved in emergency medical service tends to develop his or her own, personal relationship to death.
This relationship does not only affect our social way of dealing with death and the process of dying – in fact, as I had to observe in myself, it changes one’s whole perception and attitude towards life in general.
This is what this book is about.
I would like to share my story with you and offer you the opportunity to „turn the tables“.
This is my invitation to you to join the development of my attitude towards life and death and to follow its change throughout the years.
For reasons of respect and in order to protect personal rights, I changed or even erased the names of all people involved as well as the places where events occurred.
Introduction
Time and again it comes across – in our professional as well as in our private life – and I can never guess beforehand what it does to me or how it might leave me behind – death.
In which way does it deal with me?
An how can I deal with it?
Obviously I can do different from the most so-called „common people“ – but why is this?
Why am I the way I am?
This is the original approach, the idea this book was born from. To be able to comprehend the following stories, you might like to join me on a short biographical trip. Like probably every one of you, my first cognition of death and dying did not occur to me after the entry into adult life, but far earlier. And even although my job is for sure one of the strongest influences, it is not the only factor that shaped my development and views of life.
The first experience I can retrospectively identify as path-breaking occurred during my childhood, which I would generally describe as „usual“.
Under largely intact circumstances, I grew up as the youngest son of a family of five in a suburbian tenement of a German major city and completed my regular school career without any major abnormalities.
The only fact worth mentioning may at best be that I have been involved with the youth department of the local voluntary fire brigade since the age of 13 and consequently joined the active fire fighters at the age of 17 years. Of course, the reason to mention this is not the putatively outstanding unsalaried social commitment behind it – happily there still are lots of people all over Germany and the whole world who do so.
All of them deserve great appreciation for what they do every day.
Moreover, this path I chose holds a big share of my general attitude and – as you will recognize during the following chapters – had some events in store for me that were made to challenge me, to touch me and even to lead me to experience my personal limits.
Furthermore, my temporary nursing job at the emergency room of a local hospital during my time as a medical student at the university as well as different necessary medical internships before entering the actual medical working life offered me some insights Joe Bloggs usually is spared of.
The resulting blend of largely different influences helped to create my actual ego end especially my view on life and death. But please follow me on my way from the very beginning.
Just like probably to the most of us, my first encounters with death occurred to me in my family.
Chapter I: My Grandparents
Grandpa
Just like almost every child I loved my grandparents, at least those of them I was granted to get to know.
My paternal grandfather died a long time before I was born – a fact, I never questioned in any way during my childhood.
Anyway, family bonds to my maternal grandparents were far stronger than the relationship to my paternal grandma, which was characterized by a certain interpersonal tension between my parents and her.
I spent many wonderful summer holidays with my parents at grandma’s and grandpa’s leased ranch. My grandfather and the next-door farmer brought country life, farming and the handling of the farm animals closer to me and made me imagine the job profile of a farmer as my future dream for a while.
Unfortunately, my grandfather was the first one I had to experience the subject of death with. He died of colon cancer when I was seven or eight years old.
Due to my age I had neither recognized his sickness nor the progress of it and so I saw his death as a simple fact of „no-longer-being there“ or „never-being-there-again“, to put it in tougher words.
This was a kind of absoluteness I could not quite comprehend and could accept even less at this age.
I remember that, in relatively close temporary context, my favourite pony „Meike“ on which – thanks to my aunt - I had learned to ride, also died on my grandparents’ farm.
As morbid and inappropriate this connection of thoughts may appear – this coincidence made me aware of the fact of finitude of all being for the first time.
I can still remember my reaction to this very clearly. Facing these inevitably facts I was lying on my bed crying when my mother came to me to find out, what was the matter and to comfort me. I explained it to her with the words and the view of a child in primary school: „It is so unfair, we all have to die!“
My dominant thought was about death being something unswayable, which I considered absolutely unfair as I was certain about that one fact: Neither Grandpa nor Meike had chosen to die.
The fact that the main concern of her seven-year-old son was not about having lost his grandfather, but the resulting fear of other people also having to die, my parents in first place, may have been astonishing to my mother to a certain extent.
Grandma Hertha
As I explained beforehand, my relationship towards my paternal grandmother was characterized by different influences from the beginning, which I was not able to identify at a child’s age.
Regularly, the atmosphere between my parents was already tense every time we went to visit her and even the trip to her place (taking roundabout one hour and thus being only half as far away as the ranch of my other grandparents) had always been problematic. There used to be quarrels leading my father to feeling unease and even a perceived circulatory weakness.
These circumstances combined with the fact that Grandma Hertha generally seemed to be less vital - which she herself actually felt and proclaimed repeatedly - may have affected my way to deal with the event of her death. I experienced it totally different from the death of my grandfather five years earlier:
She had always appeared (and biologically objectively was) older and less active than my other grandmother. I felt that somehow she had always complained about physical frailty, weakness and limitations.
She died when I was 13 years old.
Partly due to my age, particularly rather due to my felt certainty that „now she was in a better place“ where she presumably could enjoy her actual being jauntily, I did not experience her death as something too „terrible“.
This feeling even led me far enough to find it hard to understand some of the unfamiliar emotional reactions my father showed.
In retrospection it is objectively clear that he had just lost his mother – regardless of any previous problems one of the biggest possible losses a human has to face in life. And yet I somehow had difficulties to understand his grief as I was convinced and inspired by the certain feeling that she was better now than she was before.
However, regarding his situation and my family role as the youngest son just entering adolescence, I could not find the courage to tell him what I felt.
Furthermore it seemed inappropriate to tell him that I had met her in one of my dreams where I had got the impression that she was doing unusually well.
Being a soldier for his whole lifetime, this kind of esoteric thoughts had never been his style anyway.
