D is for Donna


Laurie Cruz, MD1

Perm J 2019;23:18-263 [Full Citation]

E-pub: 06/24/2019

You’re one of the few people who really know me. You never said, “Don’t take it personally,” or “You are too emotional.” You knew me, and with that came your love and support.

You asked if my husband would take care of me, and raised your right eyebrow when I insisted I didn’t want to be taken care of. You smiled when I told you my second husband would always take care of me.

You wanted my life to be easy, yet you supported me going to medical school when I was 32 years old.  You questioned how I would be able to handle children dying when I told you about pediatric palliative care. You didn’t have your own palliative care team yet, but they would come soon. And you said, “You can do it.”

When you dropped me off freshman year you cried. I thought it was ridiculous. I’m sure I rolled my eyes and ran up the stairs to my new room—my freedom. You weren’t sobbing or wailing, just holding a tissue in your right hand, the back of your left hand to your mouth, as I find myself doing these days. Just a few tears escaped your eyes as you sat in the passenger seat and Dad drove away. I breathed. Thirty-six years later, I told you that I had dropped my son off at college and that I had cried. “Of course you did,” you said. It was one of the most coherent things you had said in months.

I learned a term last week called “ambiguous grief,” which is what I am experiencing.  You’re here, yet you’re not. I would call you, but you don’t understand how to use a phone. I visit and tell you about what’s going on in my life, and sometimes you ask me about the dog you see on the floor. I ask how to keep my tomato plants alive, and you smile, nod your head, and say, “That’s good.” Because you’re here, I will continue to read to you like you read to me when I was little. I’ll tell and retell the story of us dropping lampshades at Target and laughing uncontrollably until those ladies asked us to leave. And I’ll give laminated copies of your chicken tetrazzini recipe to Eli and Gillian even though they were never taught to read cursive.

I think of you when I text or email funny things to the kids, fondly remembering the newspaper and magazine clippings you sent me with notes in your beautiful handwriting. I never could forget your “D.” I have always been envious and proud of that distinct cursive. You drew one of those D’s the other day when you signed your name to allow me on your Health Insurance Portability and Accountability Act form, just like you did when you wrote “Love, Donna” on a Valentine’s Day card for Dad earlier this year. You tried to eat and the food fell off your fork, so you lifted the empty tines to your lips and opened your mouth.

But you had made the D.

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Disclosure Statement

The author(s) have no conflicts of interest to disclose.


Kathleen Louden, ELS, of Louden Health Communications performed a primary copy edit.

How to Cite this Article

Cruz L. D is for Donna. Perm J 2019;23:18:263. DOI: http://doi.org/10.7812/TPP/18-263

Author Affiliations

1 Department of Pediatrics, Highlands Ranch Medical Office, Denver, CO

Corresponding Author

Laurie Cruz, MD (laurie.d.cruz@kp.org)

Keywords: ambiguous grief, palliative care


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