First responders, medics carry burden when deaths occur
FREDERICK, Md. (AP) — Frederick police Sgt. Andrew Alcorn vividly recalls the first time he and another officer told a Frederick couple their son had died in a car crash.
Such difficult situations are touched on in training — the subject comes up in the Frederick police academy’s training block on death investigations — but most rookie officers learn much more about how to react by doing what Alcorn did 10 years ago; watching a veteran officer.
“The mother took it very hard, she fell to the floor, she was wailing and crying; incredibly upset, and I remember the older officer was very sensitive to the family, consoling them and even hugging members of the family,” Alcorn said. “As a younger officer, I was a little taken aback at first by how empathetic he was, it really opened my eyes to the fact that you can open up on this job. There are times when it’s almost required.”
For police officers and doctors alike, telling family members a loved one died is part of the job.
In the years since, Alcorn has himself taken on the role of the veteran officer in several other notifications, learning as much as he could about how to read people’s reactions and family dynamics while still doing his best to remain open and earnest with the family.
New officers are taught to avoid using euphemisms or phrases like “your family member is in a better place,” or “your loved one has moved on,” preferring instead to use more direct language, while remaining as sympathetic as possible.
Frederick police send two officers on death notifications, preferably a male and a female, along with one of several volunteer chaplains the department rotates between to assist.
“Males and females generally react different to different news and, depending on the different dynamics, one officer may appear more sympathetic than another to those individuals we’re talking to,” Alcorn said. ”. . . We just want to cover all of our bases and make things as smooth and as easy for the family as possible.”
If the death was the result of a crime or the subject of an investigation, a pair of detectives replace patrol officers and, depending on the circumstances, members of the department’s Victim Services Unit may also be requested, Alcorn said.
Police always make notifications in person, unless multiple attempts to reach the family failed and there is no other way, Alcorn said.
For example, the first notification Alcorn made with the veteran officer resulted from a crash that took place outside of Frederick County, but because the family lived in the city, the agency handling the crash asked FPD to make the notification.
“If at all possible we are not going to make notifications over the phone . . . that is our last resort,” Alcorn said.
Dr. Kimberly Zuzak remembers a crazy night on the cardiology floor.
Cardiology departments often have high-risk patients, and that night, there were several simultaneous codes, indicating medical emergencies, such as cardiac arrest. One of the patients died.
Zuzak, now the medical director and division chief of hospital medicine at Meritus Medical Center, had to call the family. It was one of her first death notifications.
For doctors like Zuzak, death notifications are part of the responsibilities she has. They can be taxing on the doctor as they give families life changing news. But, Zuzak said, when done right, they give doctors a way to help someone handle horrible news.
In the hospital, deaths are both unexpected and expected. When there is a change in status, indicating someone worsened, families receive a call. When Zuzak called to say the loved one died, the family was somewhat prepared.
There are some death notifications that doctors don’t forget, said Dr. Jonathan Wenk, a medical director in the emergency department at Frederick Memorial Hospital. For Wenk, the hardest ones are children.
“It’s never easy,” Wenk said. “It’s one of the hardest things you might have to do in the field of medicine.”
One of the early ones involved a 7-year-old boy who died after being hit by a car while riding a bicycle.
Doctors strive to give death notifications in person, Wenk said, although some might be done over the phone. In Zuzak’s case, the family had left the hospital when their loved one died.
There is no one-size-fits-all approach to delivering a death notification. A doctor will tailor each one depending on the circumstances. Was the death expected? Young? Old?
People handle negative news differently, as it is a major psychological event, Wenk said. Some might lash out in anger, others might physically attack. Wenk tries to keep support around him in case.
Wenk helps the family come to terms with the loss of a loved one by talking about the person, he said. Zuzak works to develop a relationship with her patients, and when they die, she tries to take care of their families by giving her time to the family and talking with them about the loved one.
For Zuzak, the harder notifications are those she gives to families of patients she did not know. In those cases, doctors can still be empathetic.
Death notifications take a toll on the doctors that give them, Zuzak said.
“I think we would like to think it doesn’t, but it does,” she said.
Each hospital has resources for their doctors to help with the psychological tolls associated with the job. Wenk and Zuzak also look out for their colleagues, especially the younger physicians.
“In order to be able to take care of our patients, we have to be able to take care of ourselves,” Zuzak said.
While doctors might need a moment to compose, they often have to immediately jump back to the next case, Zuzak said.
While police get some training in the academy, neither Wenk nor Zuzak learned how to deliver news to families in medical school. Instead, both learned in their early residency years from watching attending physicians and older residents.
“You sort of learn by doing,” Zuzak said.
But now medical schools are starting to teach students through simulations, training modules and practice scenarios, said Dr. Norman Retener, director of Longitudinal Undergraduate Medical Education at University of Maryland Medical School.
With simulation, students can practice how to deliver news and receive feedback in a less stressful situation, Retener said. By the time the students enter their internship and residency, they should have a better grasp of how to deliver death notifications.
Wenk and Zuzak feel that they would have benefited from such training.
In the hospital, chaplains can offer support for families before or after death, said Karla Davis, a chaplain at Meritus Medical Center. Chaplains do not deliver death notifications.
Chaplains ask how they can be there for families and what they need, Davis said.
“Well, the most important thing is just being there,” she said.
Chaplains, who provide a perspective outside law enforcement, are also helpful to police agencies, and most departments maintain a group of voluntary chaplains from local denominations.
Jonathan Purks, a pastor at Victory Baptist Church on Himes Avenue in Frederick and a volunteer chaplain for the Maryland State Police’s Frederick barracks for more than four years, has participated in more than a few death notifications alongside state troopers.
Despite his experience, Purks said he never truly feels prepared to carry such a heavy burden.
“It is a very difficult aspect of what we’re called on to do as far as being a volunteer chaplain because you’re going into a scenario with, first of all, probably one of the most devastating pieces of news that anyone could hear, and many times we are the first line of communication,” he said.
Because the types of deaths to which police respond happen as the result of accidents or otherwise unexpected circumstances, the news is even more jarring for families, Purks said.
“Many times, these people are in the prime of life living life to their fullest, they may even be young people with their whole lives ahead of them and all of that is kind of weighing on your mind as you’re making your way to the residence, thinking, ‘how am I going to say this?’” Purks said.
Some situations are noticeably more daunting than others, such as when, several years ago, he and state police responded to the home of a family whose mother had just been found dead in a parked car.
Police quickly determined that the woman took her own life, and Purks found himself being addressed by her 12-year-old son.
“He looked right at me and he asked me, ‘Why did my mom do this?’ And what do you tell a 12-year-old boy who asks you that?” the pastor said.
Purks has picked up on many of the same strategies and guidelines that police are taught regarding the need to choose his words and phrases carefully, as well as how to read people and reactions. He often finds it helpful to know as much about the family dynamics and the deceased person before he arrives, if there is time and the information is available.
More than anything, Purks said he uses the word of God and offers his faith to those open to it.
His faith also helps him accept the burden that making death notifications imposes on him and his mental well-being.
“The thing that I am confident of is that the Lord has created every individual and I can kind of rest in the fact that He’s in control,” Purks said. “Knowing that, if it helps someone else that I’m in the place I am and playing the part that I’m playing, then it’s worth my doing it.”
Information from: The Frederick (Md.) News-Post, http://www.fredericknewspost.com