Studs Terkel, “’You Got Into My Heart Violently, But You’re There,’ Trauma, Death, and Forgiveness on the Frontlines of American Life,”
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Studs Terkel, who put oral history on the American map with one spectacular book after another, was a small man who had a knack for making everyone around him feel larger than life. He taught me the first significant lesson I learned as a book editor -- and he didn’t even know it. I stumbled into Pantheon Books in the summer of 1976, hired (on the basis of remarkably little) by AndrÃ© Schiffrin, who ran that pioneering publishing outfit. I had only the most minimal idea of what a book editor was or did, but on one thing I was clear: I was going to put new voices between covers. (I would later start calling them “voices from elsewhere, even when the elsewhere is here.”) I couldn’t have been less interested in well known or famous writers. I was, that is, something of a reverse snob.
Nonetheless, one day that first fall AndrÃ© came into my office with the manuscript of Stud Terkel’s memoir, Talking to Myself, which was to be published the following spring. He asked me to read it because Studs -- he claimed -- wanted my reaction. A longtime Chicago radio personality, who had even hosted an early, unscripted TV show, “Studs’ Place,” set in a fictional bar (the “Cheers” of its era), he was well known indeed. The first book he and AndrÃ© had done together, Division Street: America, had broken into bestsellerdom and neither of them had ever looked back.
Studs didn’t know me from a hole in the wall, so I didn’t take the request seriously until AndrÃ© returned a few days later to ask whether I had read the manuscript. I hadn’t. He said, “Please do. Studs is waiting anxiously.” Anxiously? That was hard to imagine, but when your boss insists... so I went home, read it, and two days later let him know what I thought. (What could you think, given that Studs was fantastic at what he did?) Soon after, he put me on the phone with Studs to tell him just how good it was and make a few modest, last-minute suggestions.
So many years later, I still remember that unforgettable voice (possibly the last on Earth out of which a cigar emerged) saying something like, “Do you really mean it, Tom?” What I’ll specifically never forget was the quaver in it, the shiver that seemed like a caricature of fear. After all, he was the best-known author I’d ever talked to and, as a young man with enough doubts of my own, it had never crossed my mind that a successful writer might feel vulnerable when it came to his latest work or give a damn about the opinion of a total nobody. In a way, that moment taught me everything I needed to know about the essential vulnerability of the writer and, thanks to Studs, I never looked back.
For years, AndrÃ©, who was his editor, would call me in to take a final look at his oral histories. (It was like sending in the second team.) Only after I left Pantheon did I became Studs’ primary editor. It was the experience of a lifetime. Just to give you a little taste of the man, I'm including excerpts from the only letter of his I still have, typed by hand, filled with X’d out words, and further hand-corrected in pen. It came with the first batch of rough interviews for the final book we worked on together, an oral history of political activism aptly titled Hope Dies Last. By that time, Studs was in his early nineties and still a human dynamo. Maxwell Perkins, whom he mentions, was a famed editor who joined the venerable firm of Scribner’s wanting to publish vibrant young voices and ended up working with, among others, F. Scott Fitzgerald, Ernest Hemingway, and most famously the novelist Thomas Wolfe who simply couldn’t stop writing, which meant that his books involved marathon bouts of editing. Here, then, are the first two paragraphs of that letter in his telegraphese.
“Post-election day,” Studs began. “A hell of a time to write about hope... The ton of stuff -- good and less than good. Since what you have is the raw stuff -- I have already tossed aside about 20 [interviews] -- I shall, of course, begin my cuts shortly after you receive this messy letter.
“You’ll be my Maxwell Perkins, though you don’t wear a hat, and I’m your Thomas Wolfe, though a foot and a half shorter than he was...”
And here’s how he ended: “I’m eagerly looking forward to your reactions when you get this bundle. Horrified [though] you may be by its bulk, remember you’re my Maxwell Perkins. If it works out, I’ll buy you a hat.”
What a guy (even if I never got that hat)! I always considered it appropriately Studsian that the book preceding Hope Dies Last was his oral history of death, Will the Circle Be Unbroken?: Reflections on Death, Rebirth, and Hunger for a Faith. Studs himself died in 2008. Circle has just been reissued in paperback with a new Jane Gross introduction by the New Press, the publishing house that AndrÃ©, who died last December, set up after he was forced out of Pantheon by Sy Newhouse, the right-wing owner of its parent company, Random House.
Given the grim panorama of death these days -- from beheadings to pandemics -- and thehysteria accompanying it all, I thought it might be both a relief and a change of pace atTomDispatch to turn back to Studs’ oral history of death, which as its editor I can testify is moving and uncannily uplifting. That, of course, is not as odd as it sounds from the man who was the troubadour for the extraordinary ordinary American. Thanks to the kindness of his publisher, the New Press, I’ve chosen two interviews from that book which stayed in my mind these last 13 years: the first focuses on an impulse that may be among the hardest to understand and yet most moving to encounter, forgiveness; and the second, from this country's medical front lines, centers on a subject that, unfortunately, is still all too timely: the trauma deaths of young Americans from gunshot wounds. This is the only book I ever remember editing while, in some cases, crying. Tom Engelhardt
“You Got Into My Heart Violently, But You’re There”
Trauma, Death, and Forgiveness on the Front Lines of American Life
By Studs Terkel
[The following is excerpted from the new paperback edition of Studs Terkel’s oral history of death, Will The Circle Be Unbroken?: Reflections on Death, Rebirth, and Hunger for a Faith, with special thanks to his publisher, the New Press.]
"The Other Son"
In contrast to her husband’s introspective nature, she is outgoing, a large-boned woman, overflowing with gusto and ebullience. She frequently laughs out loud.
I’m a forty-six-year-old woman of Jewish-Gentile descent -- my father’s a Jew, my mother’s a Gentile. My parents divorced when I was young, and I was raised by my stepfather -- raised Catholic. He was a truck driver. My younger brother, Mark, became a truck driver. I went to public school. But I went to the Catholic catechism every Wednesday. I did the confirmation and all that kind of stuff. I got close to age twelve, thirteen, and I began to see what I was saved from. I was saved from Hell. But what Catholicism wasn’t teaching me was what I was saved to. They didn’t tell me how to live with God and experience a taste of Heaven on Earth, now. So I began to pull away from the Church. It just didn’t meet my needs.
If I read my Bible I saw that it said very clearly to worship God, then why were people worshiping statues? To me that looked like idolatry. So, as a young teenager, I started asking questions. Then I began to wonder what is this all about? I know that there’s a God, and I know that He loves me, but what else is there? How do you live now? I lived in a very difficult, alcoholic home, and early in my teens began to experiment with drugs -- do whatever I felt like doing. In the one sense, I had the Ten Commandments ingrained in me, so I knew what was right and wrong -- but I didn’t really care about the consequences. I didn’t really understand the value of a God who loves me, and that because He loves me, I should act loving towards him, which means act loving towards everybody else. I was very, very selfish.
I had been working part-time jobs since I was fourteen. A couple of weeks after I graduated from high school, my dad said, “Get out of the backyard, sitting in your bikini, and get your butt downtown and find a job.” So I went downtown and found a secretarial position. I was seventeen. And then I moved out when I was eighteen, to live with my boyfriend. That didn’t work out. Moved back home and met Steve not that long afterwards, in March of 1975. We moved up here to Rogers Park and had a family. We had twins in May of 1977, Andrew Needham and Samuel Richard, born on different days -- May 7 and May 8. And then in 1982, in August, we had Philip; and then in 1987, December, we had Clinton. I was working as a floral designer, part-time, in Skokie. Steve was tuning pianos.
Andrew went out to cash a check with his brother and didn’t come back. He was shot by a young man who had easy access to a handgun and who had graduated from high school the day before and was looking to move up in the gang that he was in, the Latin Kings. He shot Andrew, probably because Andrew didn’t back down with his mouth. He knew that gang members were idiots and didn’t mind telling them what he thought of them when they made signs at him. He was in our car.
When I got to the hospital and found out that he was gone, and I asked the boys what happened and they told me, I said, “Well, you know what? There’ll be no retaliation for this. I just want to make that clear.” Men usually want revenge; women, too, but men usually much quicker. Women will stew for a while. I knew that revenge was wrong, but I also knew that I hated what these kids had done and knew that they deserved to be punished. I pulled out some old journals from that time. These notebooks. Here’s an entry that I wrote July 13th of 1996. Andrew was murdered June 10th of 1996. It reads: “It’s been sixty days since Andrew left us. Forced out of his body by Mario and Roberto. Please, Lord, let justice be served. Plus, punish them. Let them not have a free life.” That’s how I felt. I did not want them to be free, and I was real glad that the police had seen what had happened.
I’m going to backtrack a tiny bit. My twins were three months old. I was sitting on the beach with them. Somebody came up to me and said, “Could we talk to you about Jesus?” And I said, “It’s a public park, it’s a free country, you can sit down.” So they started talking to me about Jesus. This lady turns to me and she says, “So how’s your life?” And her words shot into my chest like a sword. I’m thinking, Oh my God, what does she know? I had just had the twins. I was not coping. I was smoking massive amounts of marijuana. I was up twenty-four hours a day, not knowing how to keep these little babies on a schedule. I was fantasizing throwing one of them out the window. I was having what now I understand to be severe post-partum psychosis. I didn’t have any help. I was really just trying to hold on... So I began to tell this lady and her friends how poorly I was doing. She said, “Would you like to commit your life to Christ again?” And I said, “I really would. Because I realize I’m not doing very well by myself. Something is missing.” So I did that and I prayed that day. Since that day, I’ve been learning how to parent, and to let God love me, and to love and forgive others.
Nineteen years later, when this happened with Andrew being murdered, I said, “OK, I know who I’m following.” What would Jesus do? It was pretty clear. He says: Love your enemies -- I consider these little guys my enemies that killed my son. Pray for those who use you, forgive as God has forgiven you. So I thought, OK, what does that mean? Looking back at another journal... this is from January of 1997. I wrote: “What are the obstacles to forgiveness? How can forgiveness free us? How can it free me? Well, first I needed to know that I must face my own pain and grieve. And not keep anger on, sort of as a suit of armor. Admit the wrong that was done to me and experience the rage. But be honest with God about my pain and why. Releasing my anger to him and pardoning the offender makes me feel vulnerable, even out of control. But what’s my choice? If I hold my anger, it will destroy me.” And then I also wrote, “It’s OK to be afraid of being hurt again.” So, obviously, the whole idea of forgiveness was there in the back of my mind the whole time, and I kept thinking: I want to kill them, I want to see them fry. But God says forgive... And I kept going back and forth thinking, How do you do this? Scratching my head. Then I realized I could make the choice and trust that the power to do it would be there. Because I know that my faith, which is just my yes, is the glue that holds God’s power to his promises. And He’s promised that He would do what I ask, He would do the right thing in my life. I’m going to have the faith and forgive and trust that He’s going to take care of it all. So I finally did that about July of 1997, about six months after what I just read to you. I forgave and wrote Mario in prison a letter. He was eighteen, my son was nineteen. I told him about my life. I just wanted him to know how I was raised, and that I had done plenty of things that needed forgiving and God forgave me. So how could I withhold forgiveness from him? I couldn’t. That I love him and God loves him and I forgave him.
I didn’t know that at the same time, he was writing me a letter. As I remember, he was begging forgiveness, saying how sorry he was, how he wished he could bring Andrew back, even trade places. And I believed his letter was sincere. But his letter was unnecessary for my forgiveness. I had been asking to see him.
It’s one thing to write to someone and say you forgive them -- it’s another to physically touch them and say you forgive them. It would help me in my healing and him in his, I knew. I felt compelled to do it. I had been asking through his priest when was a good time. Mario kept saying, “I’m not ready. Mrs. Young is pushing too much. I’m not ready.” He was terrified. He thought I might hit him or something. He was not ready to face me. That was July of 1997. I didn’t get to see him until December 17th of 1998. So it took more than a year and a half before he was ready. And I waited. We did correspond. And then I went to visit him with Father Oldershaw, and a retired schoolteacher by the name of Arlene Bozack. She had been visiting him.
When we first got there, the assistant warden, who was Hispanic, was crying. He said, “Mrs. Young, why are you here?” I said, “Well, I’m here to offer forgiveness to the young man who killed my son.” And he said, “Why?” And I said, “Because I care about him, I love him. It’s the right thing to do. I want to do it in person.” He said, “In all my years, this is the first time I’ve ever seen this happen. I really commend what you’re doing.” He was this big, tough-looking Hispanic warden.
I see Mario for the first time. He couldn’t look at me. He had his head hanging down. They sat us around a small round table with four attached seats, told us where to sit. Everybody kept looking at me very suspiciously, like I was going to just jump on this kid and beat the hell out of him. Mario’s got his head hanging down, and all of a sudden he kind of looks, and he can’t make eye contact. I saw that his whole body was starting to shake. All four of us prayed. It was me, Father Oldershaw on my right, Mario was across from me, and Arlene Bozack was to his right.
I grabbed both Mario’s hands from across the table, and I looked at him in the eye, and I said, “I just want you to know that I’m glad to be here.” I knew I had to go first. He just shook his head. Slowly, but surely, the conversation started. Little chitchat, we all took turns talking. I wanted to know about his family and how they were doing. Because the shame that he brought on them -- especially being an Hispanic family -- that’s so important. And then the conversation changed a bit because I felt like, OK, it’s time for this little guy to hear what he’s done to us. The consequences of his actions. I began to tell him the difficulties that each of our family members was having. As I went through, person by person, saying, one young man’s suicidal, the other one can’t focus, or whatever the problems were for each of us, he listened. He held Arlene’s hand and he trembled and he wept, but he listened.
At some point in the conversation I said, “I love you like you’re my son, like you’re one of mine.” And I was like, “I can’t figure out how this happened!” [Laughs] I thought I was nuts. I didn’t tell him that. I was thinking, I gotta be crazy. So I said, “I love you like you’re my own son. You got into my heart violently, but you’re there. So this has to be a miracle. God did this. Because I didn’t do this. But, as a son, you have responsibilities to know what’s going on and to pray for us, to communicate with us regularly. You’re part of the family now.” Then he pulled out his Bible. I said, “Mario, there’s a Scripture that meant a lot to me and helped me take this step. I wanted to tell you what it is. It’s in Romans, in the twelfth chapter. It says, ‘Never pay back evil for evil to anyone. Respect what is right in the sight of all men. If possible, so far as it depends on you, be at peace with all men.’” I said, “My reaching out and extending and forgiving was my responsibility, and it didn’t depend on whether or not you accepted that forgiveness. I had to do that.” It also says, “Never take your own revenge, but leave room for the wrath of God.” Then I said what was really important was when I got to verse 21. It says, “Do not be overcome by evil, but overcome evil with good.” I said, “Mario, that really meant a lot to me. Because I wanted to win. I did not want this evil thing that you and Roberto did to us to win. I wanted good to win. So that’s why I forgave you and that’s why I love you.”
He was speechless. He looked at me like I had two heads. [She roars with laughter.] He stared at me like: I don’t know what she’s talking about -- she’s from another planet. It wasn’t quite sinking in. But he was listening. I heard later that he was confused and didn’t understand it, but it was beginning to make sense. He was actually holding his Bible open to this spot, looking at it over and over and over again. We talked, and then I got to hold him. That was really, really special. Here’s another reason I thought I was crazy: I’m sitting across this little table from him, and it’s all I can do to stay in my seat. I’m thinking: What’s wrong with me? Am I having a nervous breakdown? Everything in me wanted to leap over the table, grab hold of this kid, and rock him like a baby, just hold him. The urge was so overwhelming. The compulsion was so overwhelming, I was afraid that if I couldn’t keep control, I’d be in really big trouble with the guards and the warden. So I resisted that urge the whole time.
On the way back home, I was thinking about it, and then I talked to Arlene and Father Oldershaw. I said, “I’ve got it! I know what was happening. I was getting a taste in my body of how much God loves us. He loves us so much that He wants to leap over the table, grab hold of us, and just rock us because we’re his children.” That love, that forgiveness -- I got a taste of what it must have been like for Jesus when he was here and walked the Earth among people that he loved so desperately, so wonderfully. I got a taste of it!
As time went on and we kept corresponding, I did go see him again there, and it was good. I really began to see him maturing, through his letters and through visiting him. I was training him, I was mentoring him -- to help him to grow up, to help him in his spiritual walk. His letters changed. They became clearer, he became more willing to take total responsibility. I saw no excuses anymore, I saw a person that was squarely saying: This is where I am and this is where I should be, and God’s changing me right here, and probably being here saved my life. He’s working as a chaplain’s assistant now... [Sighs]... I’m convinced that if I did not forgive and I held on to my anger, that I probably would have become mentally ill. Maybe killed myself, maybe hurt someone else. I felt like God’s hand was on me and he was squashing me into a pancake: You gotta do this -- this is the right thing.
I knew that there were great things ahead, although they terrified me, the thought of going out into new territory. Because, I’ll tell ya, I was not a very forgiving person most of my life. I used to hold things against whoever did what to me. It really took the murder of my son and the forgiving of his killer to teach me how to forgive everybody around me. I began to realize: My husband’s not going to be Mr. Perfect. My parents haven’t been perfect parents. My children are not perfect children. My friends are going to let me down. That’s a given. Because they’re human, like I am. There is one perfect, that is God, and He loves me. And that’s good enough for me. So, by forgiving them, like I did Mario, it freed me to really love. My love was, like, stopped up in a bottle or something. It came out in little bits. But for the most part, it was stopped up until I forgave this kid. And then it was like whoosh -- this is what I’ve been missing my whole life. [Belly laugh]
I saw Mario just this last month. I’ve met his mom and his dad. They don’t speak any English, but usually one of his sisters is there to interpret. Most of the time, all his mother can do is hold on to me and cry. She’s a very sweet person.
Dr. John Barrett
He is Chief of the Trauma Unit at Cook County Hospital, Chicago. He still has an Irish brogue.
"In 1966, the Trauma Unit here was actually the first of its kind in the nation. It’s dedicated to people who, more than being sick, are injured -- patients who have been subjected to what we call intentional injury, violence. It’s gunshot wounds, stabbings, personal assaults. Other trauma centers see patients who predominantly are victims of unintentional injury: automotive wrecks and falls. Our experience here has been inner-urban, lower-socioeconomic groupings; predominantly young, predominantly male, and predominantly penetrating trauma: gunshot wounds and stabbings."
I am the third of four sons. My father was a mail carrier, my mother was a dressmaker in Cork. The family really struggled to make sure that all of the sons went to university. My two elder brothers did science -- chemistry and physics. I wanted to do something that was scientific in nature but more people-oriented. There was really no family tradition of medicine, but medicine seemed to fill my criteria. I can recall my eldest brother, Frank, saying, “This is a terrible waste of time -- you don’t have to be intelligent to be a doctor.”
It’s not as if it’s rocket science. There’s nothing terribly difficult to understand in medicine, there’s just an awful lot of it that you have to remember. I always wanted to be a general practitioner. In my final year of medical school, I did a rotation with the then-professor of surgery, and I loved it. At the end of the rotation he said, “Well, Barrett, what are you going to do?” I said, “Well, Mr. Kiley, sir, I’m going to be a general practitioner.” He looked at me and said, “Barrett, there’s the makings of a great surgeon lost in you.” So that’s why I decided to do surgery. I realized that what I really, really enjoyed was the injured patient. It’s such an acute event: the patient is perfectly healthy, then something traumatic happens, and within a matter of seconds they are injured. They’re a great surgical challenge because they’re bleeding, they generally need surgical intervention. The epitome of those patients is the gunshot wound. Despite all the terrible things you hear about Northern Ireland and all the violence, where I was in the South we saw no gunshot wounds. I actually had to come to this country to see gunshot wounds.
I have found that surgeons have a certain personality. They tend to be very action-driven, very egocentric, frequently overconfident -- especially trauma surgeons who will act very quickly with a minimal amount of information. That may not be the person you want to be your lawyer or your priest, but that’s the person you want to be your trauma surgeon. They tend to be supremely confident in themselves, and that’s why many people don’t like them. They tend to demean other people. It goes with the territory because you have to be damn confident in yourself if your job is to start cutting people open at the drop of a hat. People, when they hear that you’re a surgeon, they immediately look at your hands because they imagine there’s something unique about the surgeon’s technical ability. That’s not true at all. People have said you can teach educated apes how to operate -- I’m not sure if that’s true -- but it’s the decision-making process, not the technical stuff.
If you ask me to talk about life and death, the first thing I would think of is my patient. You begin to realize there’s not a sharp distinction between life and death. When is a person alive and when is a person dead? We have, for instance, patients who come in who are clinically dead: their heart has stopped beating, they are not breathing, their pupils are fixed and dilated. But we have them. The Chicago Fire Department paramedics are excellent -- they get them in here fast. They’ve been without vital signs for a short period of time. You can still resuscitate some of them, you can bring them back...
Was it two weeks ago? -- we had a man who was stabbed in the heart, came in clinically dead. We immediately opened his chest, released the pressure from his heart, sewed up his heart, and he actually recovered. He can’t have been dead because we got him back, but he was clinically dead. It’s not a very firm line; there’s a gradual blending from where you’re alive to where you’re dead. The people I see who are dead are in general young people who have suffered a calamitous event -- they’ve been shot. You try your best. They’re either dead when they arrive or generally die fairly quickly after they’ve arrived. You can’t resuscitate them. The first thing that strikes me about it is, it seems such a waste... You’re looking at a human body, and as a surgeon you know its intimate details: the anatomy and the sinews and the arteries and the veins, and they’re now dead. This wonderful perfect machine is now no more. It’s frequently the smallest thing that has killed them. A stab wound to the heart will kill one person and it won’t kill the next. It seems to be such a capricious thing. What I really think a lot about is when children die. When adults die from trauma, you feel they have some degree of responsibility insofar as they chose to be in that place at that time. When a child dies, you think: Why did that happen? Five minutes’ difference would have changed the entire course of events. And parents ask you the same thing: “Why did it happen, doctor?” You try to explain: “He was shot, we did the best we can.” That’s not the answer they want. They want to know why this person who was awake, alive, and healthy this morning is now dead. You don’t have that explanation as a surgeon.
The first thing I feel, I feel angry, angry that they died, that I haven’t been able to save them. To me it’s almost like a personal defeat. I know in a logical sense that’s not true. I didn’t shoot them. It wasn’t my fault that there were guns on the street.
Remember how I characterized the surgeon? The surgeon is supremely self-confident. We whip them back from the jaws of death, we have the scalpel, we have the decision, we have the technology, and we have a system in this hospital that’s supposed to save them. But you can’t save them all. We don’t lose a lot, but we do lose them. So initially I feel angry. That passes fairly quickly because I then say to myself: What could we have done that we didn’t do? Actually, we talk about it as a group: Could we have acted quicker, recognized this quicker? Because even though this particular patient is dead, we may be able to improve care for the next patient. Then I think: What a waste! A total, absolute waste. Especially now. I’m fifty-five years old. It makes you think about your own mortality. We really don’t realize what a precious gift life is. We take it for granted. I’ve always taken it for granted. My children are growing up, my daughter is going to college this year, I’m growing older, and I’m surrounded by people who are brought in, some of whom die. It is a very, very fragile thing we have that can disappear. The stuff that you worry about... Are you going to get the house painted? The basement floods occasionally. My God, the car keeps breaking down... It’s all so trivial... We should really realize that the greatest gift we have is time, and that means you’re alive.
When the patient comes in, you might see someone who’s covered in blood. I don’t see someone covered in blood, I see somebody who has technical challenges. A gunshot wound to the chest with hemothorax, we need to get a chest tube in, determine the rate of bleeding, and make effective interventions. So right then and there, I’m not thinking great philosophical thoughts -- I’m in a mechanical, operative mode. You just go boom, boom, boom... It’s like a very organized, choreographed dance. But then at the end, he dies. Then you say, “Let’s look back at the dance. Did we do something wrong, could we have done something better?” You do tend to become a little philosophical as you grow older. I’m convinced that the solution to all this violence is not surgeons. We need to somehow prevent it.
I come from Ireland, a country that has national health insurance. Every resident is insured. I’m an American citizen and I love being one, but I can’t understand why we can’t ensure that every resident of the country actually gets adequate health care. I’m so happy to work here at the County Hospital, because that’s part of our mission statement: We will not turn you away. People refer to us as the hospital of last resort. I think that that’s a very noble thing.
People say, “Why did you stay?” It’s so perfectly logical to me. Here’s what I wanted: I wanted to be a surgeon who dealt with patients who required surgical intervention. Those are gunshot wounds. I also want to be able to teach people. I think it’s important that you pass on your skills. And to even do a little research, to maybe improve the care of the patients. Patient care, education, and the research, all three things I’m doing here. The money isn’t the greatest, and there are frustrations working in the public sector -- but compared to what I’ve gotten out of it, I am one of the most fortunate people that you’ll ever meet. I would actually pay money to do this job. They pay me to do what I love to do.
When you lose a patient... I think every doctor has their own way. It’s not something they teach you in medical school, and they really, really should. Physicians and health-care people in general need to have a far greater degree of sympathy toward their patients, toward the patients’ family. No one ever taught me how to talk to a family and tell them that their loved one was dead, especially in a trauma situation. It’s one thing if a patient has, say, cancer and they become ill and then they die -- it tends to be a process. You get to know your doctor, you finally realize the end is inevitable, you may have time to talk to your loved one.
Trauma is different. What happens in trauma is this eighteen-year-old leaves the house in the morning, perfectly healthy. Then the mother gets a call at two o’clock, it’s the Trauma Unit at Cook County Hospital: “Your son’s been shot. Please come in.” When she walks in, she’ll see me. She doesn’t know me, she’s never met me before, and I am now going to tell her that her son is dead. So how do I do it? The first thing that I do is I try to put myself into their situation. What they want to know is, is he alive or is he dead? I think you need to tell them that. Some people start telling them about he was shot and he came in and we did this and we did that. They’re really trying to impress the family with the work that they did to save him. That’s not what the family wants to know: they want to hear if he’s alive or if he’s dead. That’s what I tell them. I say: “You don’t know me, I’m Dr. Barrett, I’m the senior surgeon here tonight.” They won’t even remember my name. Sit them down. Sit down with them. Look into their eyes. If you can, hold on to them and say, “It’s bad news.” And they’ll say, “Is he dead?” Or they just look at you. You have to use the word, you have to say it: “He’s dead.” If you say he’s “expired,” he’s “passed away,” they don’t hear that. You have to say he’s dead. Then, then they react. They generally go into disbelief: “No, no, it’s not true -- I can’t believe it... How could it happen...” Or they say, “It can’t be him. Are you sure? ” All you do then is you just let them grieve. I think it’s actually helpful for them to come and see the body. I think that’s important. He’s all covered in blood, there’s tubes in him. That doesn’t matter. They want to see that person, they want to see that face. I say to them, “It’s OK to hold him, if you want to kiss him, if you want to talk to him.” I think it’s important to do that because, afterwards, they’ll go through that scene in their mind over and over and over again. “I remember the night they called me from the County and I came in and this is what happened, and that is what happened...” It’s very important to put yourself into their shoes, but you’ve got to say the word “dead.” You’ve got to give them the finality of it.
I ask residents, “How would you do it?” They’re trying to explain to the family what they did: “He came in, we intubated him, we did this, we gave him blood, we gave him CPR.” The family isn’t even listening to that! They’re not listening to it. After you’ve said he’s dead, they won’t listen to anything for a long time. Once they’ve calmed down, it’s important to tell them the absolute truth. “I don’t know what the circumstances surrounding the shooting were, but as far as I can tell, he was unconscious very rapidly after he was shot. He never regained consciousness. I don’t think he suffered.” Just tell them the truth, it’s always the best thing.
When you die, you die. Your body rots. Everyone knows that. There’s no argument about that. But there is a spirituality to us. If you want to call it a soul, you can call it a soul. I think of it more as the thing that allows us to choose to do good or evil. You kind of fall on one side or the other. You tend to be on the side of the good or the side of the evil. You can personify this as being God and the Devil. You can call this spirituality your soul, or not your soul, but whatever it is, I do believe it continues after your body is dead. I’m not sure that thing that’s going to exist after I’m dead would say to itself, “I am John Anthony Patrick Barrett and I remember everything about John Anthony Patrick Barrett” -- I don’t think it’s that simple. I do believe in an afterlife, but I don’t believe that it’s up there in the clouds somewhere with angels flying around beating their wings, and God is an old geezer with a long beard.
Let me try it a different way. You do things that live on after you. Each of us, as we pass through life, influences others. You leave behind you a legacy of things you did and people you influenced. So even if you don’t believe in a life after death, you’ve had an influence. And people say, “I haven’t had any influence. What did I do? I worked in a steel mill all my life, I didn’t actually do anything. Got married, had a few kids...” Well, you did -- you had an effect as you went through life, and it was either a good effect or an indifferent effect or a bad effect. That effect continues on. I have two children, and they’re going to have influences on people and they’re going to do things. I’m also a teacher: I’ve taught lots of people, hundreds, perhaps even a thousand people that I have influenced in a very fundamental fashion. Many of them are now surgeons themselves. There’s little pieces of me that exist in all of that. So even though you’re dead, you’re not gone.
If you said, “What do I think makes me different from other surgeons?” the short answer is I don’t know... But I will tell you I think it’s a word called “empathy.” I have the ability to think and feel like the other person. I don’t know where I got that, but it’s something almost instinctive. Maybe that’s what doctors need to have. If doctors are supposed to comfort, you’ve got to understand that the person is suffering; you’ve got to kind of live in your patient’s shoes. I don’t care if you’re a Hindu or a Jew or an atheist, it’s all fine to me. I certainly don’t believe that there’s only one true religion and one true God and only one way of getting to Heaven. If you believe in your particular belief, I respect that. You’re gonna get to Heaven every bit as fast as I am, and in fact even faster probably.
I remember the first dead person I ever saw -- my mother’s father. I would have been probably four or five years old. I remember a big commotion in the house, getting dressed up and washed and cleaned and being on my best behavior. He was laid out in a morgue. I recall the body. He was in the casket. It was an open casket, and he didn’t look like granddad. It was this pale waxen look -- it wasn’t him. The second one I ever saw dead was in Ireland. I think I was probably eighteen or nineteen years of age, and I was out on my bicycle. There was a guy who had crashed his motorcycle into a car. As I arrived at the scene they were getting the body out -- and he was dead. And they were getting him out and I remember he was covered in blood. I haven’t thought about this in a million years. I remember, as they took him out, he had his watch on. I remember the second hand of his watch was still ticking. Why do I remember that? I think it was the thing that I talked about before. He was fine, and now he’s dead... but his watch is still going on.
If you had been born a hundred years ago, Studs, you wouldn’t have lived this long. Yet you’re still living a very productive and fruitful life. There comes a time when we really do have to balance that, though. Now, how do you make those decisions? These are actually not decisions that your doctor alone can or should make. Especially those of us who are technologically driven. If you were dying from something that I think I can cure by operating on you, I am going to try and convince you to have the operation. You may have a totally different perspective on life. I think medicine needs to acknowledge that. Sometimes it’s not the patient, it’s the patient’s family who say, “I want everything done.” How much of that is driven by them because they want to be able to say afterwards, “Well, we did everything”? It makes them feel comfortable...
It isn’t a huge problem in trauma because we really do try to do everything, because the patients are young. But if I am at the stage where I’m absolutely convinced that the patient is going to die but I can keep the patient alive longer, I think what you need to say to the family is not, “What do you want me to do?” What I say to them is, “If the patient in the bed could talk to us, what would he say, do you think? You know him, he’s been your son or your husband. You know his approach to life. What do you think he’d say?” Then they begin to think: What would he say? They’re surrogates. I don’t want to know what they want to do because they’re filled with guilt and anguish, and half of them want to do this and half of them want to do that. I want them to tell me what they think he would do.
Then there’s the question about physician-assisted suicide. I can understand the sort of logic that says the patient is in absolute agony, the patient wants to die, and they want me to help them to die, but I don’t subscribe to that. I think there’s a huge difference between pushing someone into a river and having them drown, and seeing someone in the river drowning and doing nothing, letting them drown. If you look at the cases of physician-assisted suicide, man, you’d better be damn sure that you’re doing the right thing. You need to be damn sure. I mean, surer than capital punishment. You need to be sure that whatever it is the patient has is totally incurable and cannot be relieved. You’re dying because you’re in intractable pain? We can take care of it, I mean, we really can. This feeling that they’re turning to say, “Kill me, doctor...” They’re not depressed? There’s nothing we can do to help that depression? I don’t think I ever personally would feel so confident that I would do that.
I actually believe in capital punishment. It’s rare for a doctor to say that, because doctors are trained in the preservation of human life. And it’s probably even rarer for a professed Catholic doctor to say that. But I believe that there are some people who should be killed. There are justifications for taking human life -- predominantly self-protection. If somebody is going to kill you and the only way you can save yourself is by killing them, then you are justiÃ¯¬Âed to kill them. That can be extrapolated into a just war, if there ever is such a thing. Now, let’s go to the individual. I don’t think we should execute people as a deterrent, although it is the ultimate deterrent for the person you’ve executed. I think there are some people in this world who are evil: they murder other people. So I would need to have a person who has committed heinous crimes, and I would include in those heinous crimes, rapes.
I also am very concerned about people who kill police officers, or even politicians, because they’re protecting us. I would also need to know that there is no way to rehabilitate him. So that might mean that he has committed the crime many times. I would need to know that he continues to be a risk. People say, “Well, why don’t you lock them up for the rest of their lives?” I’ve seen these people. They will try to kill other inmates. They will try to kill their custodians. They will try to kill the guards. They are intrinsically evil. They cannot be rehabilitated, and they continue to pose a risk to their captors. They deserve to die because they are a threat to us, not because we’re trying to frighten other people from committing the crime. They would have to be guilty much more than beyond a reasonable doubt. They exist -- I’ve seen them. There are people like that in the world.
When I’m dead, there will be this thing that is left like the body of my grandfather. That I don’t care what you do with it. It’s like when I go to the barber, he cuts my hair. Do I worry about the hair? I don’t give a damn what he does with it. You want to burn me? I don’t care. Actually, whoever is left who’s going to be responsible for my dead body, they need a ritual to bury me. So, sure, I’m sure there’ll be a little ceremony and they’ll be singing songs and ringing bells and lighting candles and smoking incense. I don’t care what they do. Because that thing in that coffin, that is not me. Now that I’m fifty-five, I actually think about dying. I didn’t think about it when I was twenty, or thirty, or forty. But I’ll soon be sixty. And there’s a whole bunch of stuff I intend to do yet. I’ve got big plans. My mother, she’s alive and she’s ninety years old; my father lived until he was eighty-six. I hope that I’ll live a long time. But I can grapple with it now: I can see myself dying. I think the process would be messy, the actual dying, death. But I don’t think I would be particularly bothered by the fact that death is inevitable. I’m not embracing death, but I’m not afraid of it. There are also the things you’ve done during the time you’ve spent on this earth that are going to remain behind, in some way, shape, or form, forever. If I’m dead and people come to my graveside and look at my tombstone, do you know what they’re going to say? They’re going to say, “Who was he?” You want to know who I am? If I wanted to have anything written on my tombstone, I would have, “Ask my children or ask my students.” I actually never thought of it quite that way. That wouldn’t be a bad epitaph.
Studs Terkel (1912-2008) was an award-winning author and radio broadcaster. His books included: Division Street: America; Talking to Myself: A Memoir of My Times; “The Good War”: An Oral History of World War II; Working: People Talk About What They Do All Day and How They Feel About What They Do; and Hard Times: An Oral History of the Great Depression; all published by the New Press. He was a recipient of a Presidential National Humanities Medal, a George Polk Career Award, and the National Book Critics Circle 2003 Ivan Sandrof Lifetime Achievement Award. These two oral histories were excerpted from the new paperback edition of his oral history of death, Will The Circle Be Unbroken?: Reflections on Death, Rebirth, and Hunger for a Faith, also published by the New Press.
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Copyright © 2001 by Studs Terkel. This excerpt originally appeared in Will the Circle Be Unbroken? published by The New Press. Reprinted here with permission.