I found myself sitting in my car outside a patient's house. I was just winding the day down and was realizing I was not prepared for this. As an Emergency Medicine doctor I have seen many upsetting situations and it is usually difficult to know which will break through. I was making a house call because the patient could no longer make it out of bed. She was dying of cancer. As this sunk in I took a deep breath trying not to let the tears fall. "You got this" I told myself but my emotions began to argue. Before being able to think about starting my car and getting out of there someone walked out of the house. I felt relieved seeing her because she was not as sick as I had feared. Small talk ensued but I realized this was not the patient. "Well come on in here she is waiting for you." Big dog just outside the room sniffed me a few times and allowed me to pet her. I was stalling. Keep petting the dog. If it gets too intense just keep talking. I entered into her death room. Now this is what I had imagined. Dark room. Everything in reach of the bed. A frail woman who looked cold in a warm room.  I had asked that she should be dressed, and she told me that getting dressed was the most painful and difficult thing she had done. I wished I hadn't even mentioned it. I sat down in a chair at the foot of the bed and began to get through an explanation of what we had to do. Not much, a couple of signatures and verification of some information and we would be done. Only problem was that the second I tried to start talking I began sobbing. Not good. Say Something I was telling myself. 

"I am sorry about this." Warm tears were flowing like a stream down my face. "My brother killed himself last year and I have not been in a hospital or around critically sick patients since leaving Emergency Medicine 2 years ago. I know this is not about me but I…" 

"How did he do it"? Her voice was strong and pissed off. 

"He jumped from a building. He wanted to jump into a volcano but the building was probably the closest he could come." 

"That takes fucking balls. I wish I had a volcano." She wanted to die.

I wasn't crying anymore. I was stunned a bit but it wasn't as painful. I really couldn't figure out what to think. I focused on the paperwork to make sure it was correct.  It was a very intense encounter for me. I don't mind talking about my brother but I have not forgiven him. She made me think that what he had done did take balls. But I miss him and I wish we could still go on cool hikes or road trips. Death is a weird one. She has helped me to understand why he may have ended his life. He has made me want to live my life with passion and without fear. Both taught me painful lessons.