Anthony Galanos, MD wants people to know what happened to his son, Nicholas. And he especially wants his colleagues across Duke Health to understand his grief about Nick’s untimely death.
“There probably are no good words,” he says in this episode of Voices of Duke Health. “So maybe we just have to acknowledge there’s no good words. I mean the theme is, everything helps, nothing works. You’re still left with biology. Your son died, he’s not coming back. So I don’t think there are words because there’s nothing that can fix it—I think what can fix it is that you just be present.”
Dr. Galanos—or Dr. G has he’s known around Duke University Hospital—came to the listening booth to have a conversation about grieving, humor, Nick’s love for the Blue Devils, and a whole lot more.
A full transcript is below.
- Learn more about Dr. Galanos at https://medicine.duke.edu/faculty/anthony-nicholas-galanos-md
- Visit the American Diabetes Association at http://www.diabetes.org
- Learn more about Duke Health Bereavement Services at https://www.dukehealth.org/support-services/pastoral-care-bereavement-services
- Grief in the Workplace, from Duke Personal Assistance Service (faculty/employee assistance program of Duke University and Health System) at http://pas.duke.edu/grief.php
Anton Zuiker: This is Anton Zuiker, one of the creators of Voices of Duke Health. Karishma Sriram, our podcast host, is a Duke medical student. She was away for a few weeks studying for her medical boards, so I’m filling in for her on this episode.
One day last November, I walked into a barbershop to get a haircut, and I noticed Dr. Anthony Galanos already waiting. Dr. Galanos is professor of medicine in the Division of Geriatrics. He’s a specialist in palliative care, and an empathetic provider who really cares about people—it shows in the way he interacts with patients and their families, and his colleagues in the hospital. But that day in the barbershop, his face was showing a lot of pain. I knew he had endured a shattering loss recently. I wanted to acknowledge his grief and also respect his privacy, but I wasn’t quite sure best words were.
So I said this: “I heard you suffered the loss of a family member. Is there anything I can do for you?” Dr. Galanos looked away, said thanks, and jumped up for his haircut.
A few hours later, I received an email message from Dr. Galanos. “Anton, It was good to run into you. There IS something you can do for me. Is there a venue I can talk about grief and grieving? Would anyone be interested?” I wrote back to Dr. Galanos and suggested he come to the Voices of Duke Health listening booth to have a conversation that would be meaningful to him and helpful to others. He agreed, and he asked Dr. Jon Bae to join him.
Here’s their conversation.
Dr. Anthony Galanos: My story changed very abruptly and suddenly on September 19th. Both my children developed diabetes, one at age 5, one at age 8. Nick as my older child and he developed diabetes at age 8. And that changed our lives indescribably. So I would say my story starts there, because it was when I started grieving for Nick. And then 366 days later, Rachel, who’s four years younger, developed Type 1. On September 19th of this year, Nick had been vomiting for a day and a half and I was with him till 1:00 a.m. that Wednesday. But he said he had Gatorade, he knew how to handle the diabetes, et cetera. But sadly, Jon, when he didn’t return my texts or calls later that morning, I just drove over to his house, unlocked the door and found him on the floor.
And there’s a blessing involved that I found him. If you were to think about what if his sister found him or his mom, they could never have recovered. I’m not saying I’m recovered, but I’m saying I can handle it better. And I, you know, jumped into action, but it was way too late, and he had changed color. He was cold. It was a horrible image and experience. I called 911. The poor lady was trying to be nice, but she kept talking to me like I was a moron. And I just said, ma’am we got to speed up. We’re behind here. I’m a doctor. I know what I’m saying. And she kept trying to give me instructions and she clearly was doing what doctors do which is she’s reading from a script instead of just responding to me. I just couldn’t get her to speed up.
At any rate the paramedics were there within minutes, certainly less than 10, and, sadly, confirmed what I had confirmed.
Whew. Terrible day. But it was just beginning because I had yet to call his mom or sister. Pshew. I won’t forget that forever. Called them, and their friends came with them. And police came and, sadly, they treated it like a crime scene. Though I explained to the officers, I’m his dad. I had a Duke badge on. I let them go through the house. I did everything they asked. But then they put that famous yellow tape around and wouldn’t let his mom or me touch him. Okay, this is hard but I gotta say it. They put him in a body bag. Brought him out. And then they let us touch. So his mom grabbed him through the body bag. This is the part I want people to know. Don’t ask me silly stuff. This is our kid. And the last thing we see is a body bag. So she grabbed his legs, I palpated up and found his head, and I kissed him through the body bag, and I said ‘Go Devils.’ That’s his favorite. Obviously this kid loved Duke and Duke basketball.
At his viewing or, in the Greek tradition, Greek Orthodox tradition, we would call the wake, there were so many people there, and they all loved him and there were some people who just walked up to his casket and cried. And I loved it. I thought you know it was a nice tribute to him. We had him dressed stuff that he would wear, including a Duke baseball cap, and a little Greek icon in the corner. And that was special and meant a lot. It was also exhausting. I would, if you were to ask one word to describe a viewing, I would call it a gauntlet. I guess like at a wedding where you get in a receiving line and you know everybody is happy for you and they’re drunk and have champagne or can’t dance like you. This was a different kind of gauntlet because every time you turned around, and if I hear the word, I’m so sorry, I just heard it too much. It just, I know where it came from, from a very good place. But, holy crap, I just couldn’t hear it again.
And then on the next day, a Saturday, was his actual funeral. It was a beautiful ceremony. I like to say that there were Greeks all the way from Denver, Colorado; Jackson, Mississippi; Houston; Mobile, my hometown, my brothers—you know everybody that mattered. It’s nice. You know, you get up at the pulpit to give a eulogy and for just that one second you have enough cognitive ability to see who’s there. And, he touched a wide group of people, including all of the guys he used to work construction with. So you had everybody from, you know, Dr. Cohen and his wife whom I adore, you know, the ultimate in academia, to these guys who framed and built barns with Nick who were there just out of love and respect. But Jon, by the end of Saturday afternoon, I was done. I was so emotionally drained. And what my two brothers did was organize a big dinner at Parizade’s, in the back room, Greeks only. It’s almost true. And we all had some good Mediterranean food and toasted Nick and then all that big table, I counted 30 something people, the next day they flew out and they were home. So back to Denver, back to Mobile, back to Jackson. And then the hard work started. You’re exhausted and all your support just left. And I have not felt that lonely in a long time.
So then becomes the second gauntlet which is, people call, they write, they email. We made Martha’s house Grieving Central. All these damn Episcopalians brought liquor. And I kept saying ‘Rachel’—that’s my daughter—’if anybody asks what I want: Poundcake. Poundcake, plain poundcake.’ So we had some good food. We had some good wine. We grieved the three of us together, very well. But eventually I went back to work first, at three weeks.
This is a third gauntlet. First was the first gauntlet, where you’ve got to call everybody you love and say your son died. Then you got to go to a wake and a funeral, and people are hugging and kissing you don’t even know and none of them brought poundcake. And then you go to work. And I know that they these are good people, for the most part physicians, and yet I felt no comfort.
If I had it to do over again Jon, I needed a work shiva. In other words, we’re going to let people know that Tony’s son died. We’re going to meet in the faculty center from 3 to 5 on Wednesday afternoon and Friday afternoon. We’re going to mourn. We’re going to cry. We’re going to wail. And then we’re done. That way you do not walk up to me in the cafeteria, or behind the HUC desk on 83 or God forbid in the CCU while I’m doing palliative care, and then you grab me and hug me, and then you walk away. And I know why you hugged me, but other people go, what is he, why did Dr. So-and-So give you a hug? Now I have to explain to a whole other group of people.
And there was a really good hearted soul that I’ve known ever since I got to Duke, and he found me in the parking deck one night, and then he goes, ‘How are you doing?’ And I said, ‘I’m fine,’ and he said, ‘No, how are you doing?’ And that’s when you know as the bereaved, they just started a second conversation. But they didn’t ask permission. They didn’t say, like we do in palliative care, is it okay if we talk about something serious? Or, would it upset you too much if I brought up your son? I don’t think anybody ever said that to me first.
Dr. Jon Bae: This was the part that I found, to me, to create the most reflection in myself. You know, you have taught me so much, the words, about the end of life and how to talk to our patients, how to talk to each other about our patients. I really have struggled to think about what are the words we should use and how can we learn from this? Because I think many of us, being one of those physicians who loves you deeply and cares for you, I think many of us were struck by how we wanted to say the right things and support you. I would love to hear your thoughts.
Galanos: I really appreciate it. And I’ve given great thought to that. I started saying, okay, if I’m such a guru, what would I have said? Well, what I would have done because of culture, and then depending on relationship, but what I do with patients and their families who I don’t really know, is I hug ‘em. Or if I don’t sense that I’d just be present and I don’t leave. I think the worst thing you can do is make a person feel like they’re in an ice sculpture in a museum. How about, G, you OK? Or let’s take a pause and just acknowledge something sad happened here. There probably are no good words. So maybe we just have to acknowledge there’s no good words. I mean the theme is, everything helps, nothing works. You’re still left with biology. Your son died, he’s not coming back. So I don’t think there are words because there’s nothing that can fix it. I think what can fix it is that you just be present.
At the Turkey Bowl last Thursday, Ryan Schulteis suddenly called everybody together before the game started. I didn’t know what was going on. They unveiled “NG” wrist bands for every player on both teams. Ryan did a beautiful talk about me and fatherhood. And they honored my son.
So getting back to your very, very good question. I think what my advice to people would be: Don’t make it convenient for you because you see the bereaved at work that you just have to go speak to them, or hug them. Maybe you should ask, “Is it OK if I ask how you’re doing?” Because I’ve seen people out in public, like at Elmo’s and they’ll walk up to me and I’ll go, “I can’t do that right now.” And they know exactly what I’m talking about. One person listened. Another didn’t. “Oh I just wanted to ask you about your son.” Argh. Can’t do it.
And the other thing would be: Do what’s good for the person as opposed to what’s good for you. Of course I’m reading books now on grieving, and one of the things that I would agree with is, don’t ask “What can I do for you?” That puts the pressure on the bereaved. So one night the Duke Marine football team called me and said “Where are you?” And I said, “Well I’m home. Where are you?” And they said, oh we’re in Durham, blah blah blah. And they said, “We made dinner for you.” They didn’t say can we make dinner for you. Can we meet you for dinner. They made dinner. They drove all the way to Chapel Hill. They dropped it off. It was delicious. It was- by the way chili is very popular at the time of grief. It was homemade chili with cornbread and it was delicious, and I realize I’m giving you contradictory advice, but that’s the nature of grief. What works for me at three o’clock this afternoon might not work at 5 o’clock. And tomorrow’s going to be a very different day.
Bae: Well, I get the sense- I mean, it’s meeting you where you are, not where we are.
Galanos: Thank you. That’s well said.
So I want people to know, if you see me don’t treat me like I’m a pariah or piranha or something scary. But don’t feel compelled that you have to comfort me because you can’t. And maybe that’s what we need to learn about grieving is that there may not be a cure. There may not be an antidote.
You want to do something good for somebody? Say, “When you go to Nick’s house, I’ll go with you.” Because that, by far, was the worst—is—the worst part. Going to a person’s home and having to deconstruct their life one closet at a time, one drawer at a time, you smell your son. You can almost feel him. But he’s not there and it’s where he died, so I found him there. I mean his home is just, talk about, it’s beyond a trigger. It’s everything.
That’s the other thing docs need to know, Jon, they’re going to be triggers and they’re everywhere. You know Nick used to work here. So there’s locations here in the hospital. I was at a Duke football game and I heard a child say, Dad! and it sounded just like Nick. And I had to go upstairs, because Nick went to Duke football with me. And I couldn’t find a private place so of all places they had a medic station and there was no one there. And I just stood, leaned on the door, and covered my face and started texting people to come get me. And then I went back to my seat and I calmed down. But here’s how you know you’re grieving. You know me well enough. I didn’t care about the game.
Bae: What are the things that you’re imagining now as the next parts of this journey? I think that’s- the next gauntlet, is there one?
Galanos: I think the lonely hard part’s coming, and the thought of forgetting what happened, that- and do I want to get over it or have closure. All that is psychobabble. I don’t want to get over it and I don’t want closure and I won’t. My mom died in 1995. There’s not a day goes by I don’t speak to her, and think of her, and use her in my teaching. And Nick’s gonna be the same.
Bae: One thing has always struck me about you Tony, and this instance is no exception, is how you have remained strong through humor.
Galanos: I love humor.
Bae: I was wondering if you could even reflect on how humor has helped you or not helped you, or- I’m just struck by it.
Galanos: Saves my life. At the Turkey Bowl, Ryan circles up everybody, they get real close to me. I don’t know what’s going on. And he starts on this, what I mean to him as a role model and I’m listening and I still didn’t know this was about Nick. And, because I’m there to beat his ass. And then he does this talk, and he’s crying, and I’m crying. And we’re surrounded by all these wonderful house officers and I just said, “Ryan I’ve got one thing to ask after all these nice words. Am I dying and no one’s here to tell me?” And they all laughed. And then they all- you know to a person—it was a great gauntlet. It was a gauntlet of hugs. And I grabbed Ryan and I said, “Of all the lowdown tricks to take me out of this game with my emotions.” You know, we just- it was just joke after joke. But what it allows you to do is catch your breath. Because grief takes away your breath. It grabs you by the throat and it says, this is not sad, this is beyond sad. This is the worst possible outcome, it’s unspeakable.
And I think there will be triggers, for a lifetime. Because I’m not going to stop loving him, and I’m not going to pretend I’m not his dad anymore. I still have two children and I’m still a dad.
Bae: Well I don’t know what else to say, Tony, other than I love you. I always have.
Galanos: Thank you for doing this, Jon, I really wanted to do something like this.
Bae: Tony, you’re the man.
Galanos: We’re doing it for Nick.
Bae: We’re doing it for Nick, we’re doing it for Nick.