“I’m so glad my parents are dead,” he casually offered, as if telling me the day’s weather forecast or some similarly innocuous and inconsequential news.

Raising more than a little bit of concern in my mind that was already reeling with possibilities, all of them quite dark, I decided to sit back, breathe, and let him lead the conversation. This, despite bursting with questions, centering mostly on the possible ill fate of this new patient’s deceased parents.

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“All things considered,” he said, without discernible affect, “I’m glad it’s over… I’m glad they’re dead, and I’m not afraid or ashamed to say it.” This is the kind of stuff that patients save for the doorknob experience; you know, that profound, therapy-altering utterance the otherwise reticent, resistant, or un-ready patient leaves you with on their way out of session, leaving you wondering if they will return to complete the story. However, this was clearly not one of those mysterious or seductive therapeutic mic drops designed to keep me wondering what would come next, nor was it a planned device strategically designed to keep me at therapeutic bay.

This was an opening to, or perhaps an invitation from this 60-something man, who seemed to have his act together—except, of course, for this most disturbing utterance. So I wondered silently, at least for now, “How and when did his parents die, why was he glad they were dead, what role if any, did he play in their deaths, and why did he so quickly and emphatically share that relief over their deaths with me, a stranger?” Murder, suicide, murder-suicide, euthanasia? Was he the culprit, the victim? The greatest challenge for me in the moment was trying to quiet my mind and let him share his story, which I was sure was going to be a whopper.

Surprisingly, he went on to talk not about his parents, but about the pandemic, which he said initially “hadn’t really hit me in any significant way.“ He was a late-career professional with a few stable income streams that allowed him to work remotely. He said he and his family were healthy, and that he had not taken any hit in income or status. He seemed content in the telling, but considering the opening salvo about his parents, I felt the need to dig a little further. Anxiety, perhaps, or maybe a masked depression because, after all, this pandemic infects everyone at one point or another, in one way or another; perhaps not physically, but emotionally. As his story unfolded, and however much I tried to ferret out this man’s hidden symptomatology, I was left with a nagging question of “Why is he here?”

As the session ended, I was left with more questions than answers, which is probably a good thing because it left me in a state of curiosity, looking forward to the next visit when more would hopefully be revealed about this man who clearly was carrying a great burden with him. But in what form and to what extent was he burdened? That was the $64,000 question.

The next session came, and as it began, I broke with my own personal and professional protocol by deciding to lead the session with a question. I asked him what he meant when he said that he was relieved that both his parents were dead. He seemed to look past me, fell into his chair as if a great weight were pulling him backwards, and then released what seemed to be a years-long held breath.

His parents, as it turned out, had died of natural causes four and eight years ago; first his father and then his mother. He spoke with neither sadness nor regret, spending little time relaying the details of their passings. As much as I wanted to ask him, I refrained. It seemed that his relief came from the fact that his parents, who lived to 97 and 98 respectively, had passed well before the COVID pandemic, not only freeing him of the burden of their care during its clutches, but also without concern of having to do so during this period of quarantine and forced isolation.

He recalled how important it was for him to be at their sides during their final descents, and how grateful he was to have been there with and for them to usher them out of their lives with the same constant and gentle compassion with which they had ushered him into his. He had become painfully aware of how families had not only been ravaged by the deaths of loved ones during the COVID pandemic, but tortured by their inability to visit family members in hospitals, convalescent homes, and hospices. Unlike his own parents, these people were dying in the care of strangers.

While these events deepened the relief he expressed when we first met, his life had recently been upended when he and his wife took over the care of her 91-year-old parents, who now resided at two different extended-care facilities; neither of which allowed visitors. Unlike his own parents for whom he and his wife had cared up to their deaths, his in-laws might very well spend their last months or years in the care of strangers—isolated from family.

The relief he felt at the passing of his parents, and the gratitude he harbored over being able to care directly for them, was slowly being eclipsed by profound sadness, anger, impotence and fear. That is why he came to see me, and it now made perfect sense. He hadn’t come to share his relief, but to express a deep guilt over abandoning his in-laws, even though that abandonment was compelled by circumstances beyond his control. When possible, phone calls, the occasional Skype, and window visits dulled the pain, but could not replace the care and comfort that comes with holding hands, hugging, caressing, bedsides visits, and vigils.

His forced inability to attend directly to his in-laws had also rekindled the fears of mortality that he thought he had buried along with his parents. His personal narrative around dying while he was caring for them was one of hope, because he envisioned that like them, he would pass in the arms of loved ones. Now, that narrative had shifted, and death seemed to be a dark and lonely place, and the path towards it frightening.

And that was where our therapeutic journey would begin.

File under: Musings and Reflections