06/09/2010 05:12 am ET Updated Nov 17, 2011

The Massey Mine Disaster: Lessons for the Living

There are many lessons that we should learn from the recent tragedy at the Massey mine in Montcoal, West Virginia. One such lesson is that despite recent accidents, mining remains extremely dangerous for those who risk their lives underground to make a living. Another is that regulations and sanctions seem to be a poor match for corporate greed. But there is another lesson that reaches far beyond these, and touches the lives of everyone who has watched the drama in Montcoal unfold.

It is tragic to lose a family member suddenly, without warning. And this is particularly true when that family member is young and healthy, with decades of life ahead. But what is ever worse, many people say, is to lose a loved one without the chance to say goodbye.
I learned that lesson most clearly not from one of my patients, but from a woman I met recently at a book signing. Shy and softspoken, she waited until the crowd had thinned and I was packing up to leave. Then she walked up to the table and began to tell me this story.
Her mother had died suddenly about six months before, the woman told me. She'd been volunteering in her local library one afternoon, and she'd begun to feel dizzy and lightheaded. Paramedics rushed her to the nearest emergency room where she was pronounced dead a few minutes later. The cause was a ruptured aortic aneurism, the doctors said. There was nothing anyone could have done.

The woman I was talking with was distraught, of course, about losing her mother so suddenly. But what really bothered her more than anything, she said, was that she didn't have a chance to say goodbye. It wasn't like there was anything in particular she wanted to say. Nor was there anything she thought her mother would have wanted to say to her, although she was less certain about that. All she really wanted was a chance to say goodbye, and it distressed her that she hadn't been able to do something so simple.

So she was surprised and relieved when, a few weeks later, a letter arrived in the mail addressed to her, bearing the return address of the hospital where her mother had died. The only thing in the envelope was a single sheet of paper -- the kind that a physician's notes might be written on. And on that sheet of paper was a brief note, in her mother's handwriting, addressed to her.

I don't know what that note said. I didn't ask. It seemed beside the point, somehow. The important thing, the woman wanted me to know, was that her mother had used her final few moments of life to write a message to her.

I was grateful that she'd shared this with me, and that's what I said. That it was one of the most moving stories I'd heard. But she stopped me, saying there was more she hadn't told me yet.

Although she was grateful to have received that letter, she was also curious. Who had helped her mother to write that note, she wondered? And who had taken the time to make sure it got to her?

Determined to solve that mystery, she went to visit that hospital and finally, after much searching, she met the emergency room nurse who was responsible. That nurse, apparently, had lost her father suddenly due to a heart attack a few years before. She hadn't had a chance to say goodbye to him, either. But ever since then, when anyone in her emergency room seemed like they might not survive until family members arrived, she encouraged them to write a note to the people who were most important to them.

If the patient lived, she'd give them the note back, or she'd destroy it. But if they didn't, she'd mail it to a family member. And she'd been doing this, the woman told me, for years. So there are probably dozens of families out there -- and perhaps hundreds -- who received a last note from a loved one because of that nurse's dedication.

But the families of the men who died at the Massey mine didn't have anyone like that nurse to help them leave a last message. Perhaps a few may have been able to, as other miners have before them. Like the miners who died in the Sago mine disaster, and many others. But perhaps not.

It's for that reason as much as any other that these families deserve our generosity and support. It's bad enough to lose a family member suddenly. But to lose that person without the opportunity for a few last words is truly painful.

And the lesson for the rest of us? It's simply that most of us will have some warning of a loved one's impending death. Maybe not a lot of warning, perhaps. But enough to say what needs to be said. So those of us with a friend of family facing a serious illness should think about what those miners' families are going through right now. We should all take advantage of the opportunity we've been given to say goodbye, while we can.