The Lost BrotherA moment of truth in the operating room
I was scrubbed and already draping the abdomen of a cherubic eleven-year-old girl whose spleen was smashed by a Jeep that had slammed into her bike on Cape Cod. The helicopter had brought her to the roof of Tufts’ Floating Hospital for Children, where I was pediatric surgeon-in-chief. I had carried her to the operating room myself, yelling at all within earshot to “move, move, move.”
Just as I handed the scalpel to the chief surgical resident, the OR phone rang. “Emergency call for Dr. Gilchrist,” the operator screeched. The circulating nurse pushed the phone up against my ear, and I pirouetted to avoid brushing her with my sterile gown. There was a crackling noise, and then a deep baritone rumble: “This is Reverend Pearson in the Tampa Bay General Hospital trauma room. Your brother, Terence, is here, and he’s dead.” He said it southern, but quickly, coldly, succinctly. “Say it again,” I replied pugnaciously, with a “come on” attitude. And he said it again. I took the phone in both hands, and demanded, in the bluest terms, to speak with a doctor.
The doctor, a surgeon, was now on the phone, as my little patient lay waiting for me. It turned out I knew him: a six-foot-six Jamaican I had helped train in Brooklyn, at King’s County Hospital, where loss of life is never unexpected. He was a gentle soul, especially that night, as he told me that my only brother was indeed “gone to God,” in his words—killed by a car traveling at forty-five miles per hour as he had attempted to cross a busy avenue.
Terence, my kind, generous, magnanimous brother, was gone. Ten hours later, I would walk the intersection where he was killed, and there in the street would find his brown loafer. He had been struck so hard that he had flown out of his shoes. My immediate thought would be to thank God that my mother was not alive to see this. The loss of a child to a parent is inexpressibly sorrowful—the most unnatural of all losses in the universe.
To be honest, the loss of my brother began long before his head struck the pavement. He was lost years earlier, in utero perhaps, when his brain was forming. He was always lost as a child, somehow different, not athletic like the rest of us but a graceful dancer. And his father never much liked him, even as a kid. My brother was lost to us for no other reason than because he was gay. He found his bliss in a world away from the mainstream, and was thus misunderstood by men like his father, the quintessential World War II veteran combat surgeon, a truly tough, alpha hombre, with the cigarette curling off his lower lip, looking askance at people who were different. It was a very narrow time, when Catholics were monolithic in their thinking and science had yet to enlighten us about brain development and neurotransmitters leading to behaviors as different as the colors of the rainbow.
Terence was lost because he was shunned. He was renounced by his dad, mourned every day by his Irish immigrant mother, who may not have fully understood it all, but somehow knew to protect him, her biology. I, seven years younger, fierce in both temperament and loyalty, became Terence’s defender. Never one to give a bully a second chance, I swung from the heels, literally in my youth and verbally later on, when anyone scorned or denigrated my brother.
I think the pain of losing Terence, and the pain he suffered for fifty years, created in his younger brother a better physician. You cannot deny the pain of loss, but you can let it wash you onto the shore of empathy, as your pain will clearly show you the pain felt by others. You can use this pain of loss to smooth back the fevered hair of the suffering, whisper encouragement to the dispirited, and fight for those who cannot fight for themselves.
The night of the phone call in the OR, the pain of loss was intense, but so was my resolve to ensure that the injured child’s mom or dad would not have to know the terribleness of such loss. I thanked the Jamaican doctor, got off the phone, rescrubbed, regowned, and approached the OR table. I opened the girl’s abdomen, mobilized her spleen, and with the quickness of a gunslinger’s hands, clamped the vessels to her cracked and bleeding spleen and saved her life.
Thus it was that the family of my eleven-year-old injured angel was spared the greatest sorrow in the world.
BRIAN F. GILCHRIST, A77, M84, is chief of pediatric surgery at Elliot Hospital, in Manchester, New Hampshire, and was formerly surgeon-in-chief at Floating Hospital for Children at Tufts Medical Center. In 2005 he was named Teacher of the Year by the surgical residency program at Tufts.