Hacker News Reader

Comment by northwest65 | Hacker News Reader

>I’m unmanned and unmoored without her

I found that quite cutting. I'm not sure I could go on if my wife died prematurely. My mind has turned to this on occassions when people close to me have suffered severe illness or died, and I just can't see in my minds eye how I could cope.

View on HN

You wouldn't be the first if you couldn't go on.

A close family friend took his own life shortly after his wife died of cancer. After over 25 years of living together, I guess it was just too much for him to continue without her.

I was too young at the time to understand and to be honest I'm still too young to understand.

Broken heart syndrome is real, elderly couples have been know to pass within fairly short time frames of each other even if all medical indications show they very well could have survived longer. Losing the one person you have shared so much of your life with, likely raised children together with and confided in is something I cannot even comprehend.

I’m going to put down HN now and play Minecraft with my wife or something, because now I feel like I’m squandering my time with her.

I have long felt that death certificates are done completely wrong. Instead of just listing the proximate medical cause, they should list the true cause: he died of loneliness; he died of a broken heart; he died because he was homeless and couldn't find his way to the help he needed.

When those are the causes of death that we start to track, perhaps the world will become a better place.

The farther you get from the proximate medical cause, the more supposition and speculation is involved.

True, but his point about missing information that could lead to the root cause is very valid. In some cases addressing the root cause is the only way to really prevent death.

The root cause of death is life.

The root cause of everything is the laws of physics and, to the extent it is a separate issue, the initial state of the universe.

Or, from a different epistemological viewpoint, the root cause of everything is God’s will.

Ascribing importance to intermediate causes is highly subjective, even assuming they can be reliably determined.

> The root cause of everything is the laws of physics and, to the extent it is a separate issue, the initial state of the universe.

Only if you think that the laws of physics are deterministic, I guess.

assumes there is a singular root cause. "he died lonely of a broken heart?" but why was he lonely? "he died because in his entire life he failed to develop relationships with people" or "he died of loneliness because he was a terrible human being" etc.

and "he died of being homeless"? why was he homeless? because society was so cruel and uncaring? sure, he had nothing to do with it himself.

the other comment is right, this path inevitably leads to judgment and speculation.

But that's not medically true? The proximate medical cause has to be valid and complete, otherwise what is the point in listing it? A death certificate provides full information as to why someone died for the relatives and for the state. This provides them with an explanation of how and why their relative died. It also gives them a permanent record of information about their family medical history, which may be important for their own health and that of future generations.

The point here is that the proximate medical cause isn’t actually the complete cause. While medical records are useful, they don’t explain the circumstances that led to someone’s death, and are therefore heavily missing information in many cases. The person who died of pneumonia because they couldn’t afford to go to hospital - all that gets listed on their certificate is that they died of pneumonia, and so we’re lacking in information that might be just as useful (or more) as that a person died of pneumonia.

If we actually understood that people literally died of not having enough money, or of lack of willpower to deal with a bureaucracy, or of homelessness, or of their mental state, there’s every chance that something might change.

That's all true, but are not the job of the death certificate or the responsibility of a doctor. It has to be as objective as possible, not a matter of interpretation, that would be an appropriate role for an inquest.

Only because we have defined the role of a death certificate as containing the immediate medical cause of death. You’re arguing that something should be the way it is because that’s the way it is.

But that's the only practical thing it could be. Suppose you shoot yourself in the head. What's the doctor supposed to put down as the cause of death? All he knows is that a bullet destroyed part of your brain. He doesn't know if you were depressed. Hell, he doesn't even know if it was intentional. Was it the girlfriend that left you last month, or that promotion you thought you were going to get that went to someone else?

What do you put down for a drug overdose? Was he chasing the next good time or escaping the pain of being molested as a child?

I think that the death certificate should either just say "yep, this person's dead", or it should list the actual reasons how and why a person died. In most cases, hopefully that'll be "this person lived out their life, and this happened to be the end of it", and that'll be self-evident because the person died of natural causes and received appropriate treatment for any illness at the appropriate stages. In others, it might require investigation. Whether it's a doctor's job to do that or a multidisciplinary team's is irrelevant to the question of what it should contain.

So either:

Doctors would also be responsible for performing inquests into non-medical circumstances of a death, for which they are not trained and don't have any powers to gather evidence or take statements. I can't see that being popular with doctors.

Doctor would not be able to sign a death certificate until a Judge had completed an inquest into the non-medical circumstances. In which case the Judge would have to do so without the benefit of a medical certification as to the medical cause of death, which would have to remain open until the end of the inquest. In which case, I don't see how the inquest can reasonable be completed without a certification as to the medical facts, which is all a death certificate is.

Neither of those make any sense, so I'm sure those aren't what you are suggesting. How do you see this working?

> The point here is that the proximate medical cause isn’t actually the complete cause.

I understand the spirit of this, but it's entirely subjective and way too open for interpretation.

I think by and large people do understand these things contribute to illness & death, they are just able to separate themselves from that reality on a day-to-day basis.

> If we actually understood that people literally died of not having enough money, or of lack of willpower to deal with a bureaucracy, or of homelessness, or of their mental state, there’s every chance that something might change.

if you actually understood the implications of following your logic, please take a moment to explain:

why do people not have enough money?

do some people waste away whatever time and money they have?

do some people fail to develop any marketable skills?

are some people just incapable of rendering valuable labor or service to anyone?

what percentage of those without money fit into that hopeless category?

what should be done about those people?

why does money exist in the first place?

how do we ensure that everybody will "have enough money"?

why do people lack willpower?

why do bureaucracies exist and what is the alternative?

why does homelessness exist?

do people in dire straits often reject help?

do people in dire straits often make things worse for themselves?

how do we force people to stop doing that?

why do people have differing mental states?

that's just for a start. then answer those questions in context of each individual life and death. but that won't be necessary if one thinks that all homeless are just "the homeless", or that all poor people are just "the poor".

but that would be oversimplification and "heavily missing information" in many cases, don't you think?

while a death cause graph database might be an interesting research tool, the big glaring problem in death certificates is mislabeled death ultimately caused by medical error. When a patient dies via a heart failure because they were given the wrong medication what is written on the death certificate isn't medical error its died due to heart failure. research funding is based around these statistics. Causes of death one of which is medical error doesn't rise as close to the top as it should.

http://freakonomics.com/podcast/bad-medicine-part-3-death-di...

> But that's not medically true?

Don't be afraid to let a little poetry into your life.

Going by the score on the parent comment, I must be the only one that assumed andrewbinstock was just trying to express a heartfelt thought.

I was indeed.

no thanks, when you go would you really want your last statement of who you were to be created by some random medical practitioner who decides on your behalf that the sum of your life was "he died a sad lonely man".

> he died because he was homeless and couldn't find his way to the help he needed.

taking your approach, you'd also have to allow at least some of those death certificates to list cause of death as: "he died because he was homeless, and he was homeless because he was a drunkard and an addict who was horrible to his family and most everyone he dealt with."

or is the intent to permit maudlin sentiments only?

Perhaps you are interpreting the parent comment a little too literally.

One thing that sucks about having a significant other die - having to keep piles of certified copies of the death cert handy, to send to various orgs / companies / etc to cancel things, shut off services, and so forth. I ran across a folder full of them a few months ago and it ruined the rest of my day.

When I called to have my late wife removed from my insurance at work, the lady who changed it messed up and removed her effective the day before she passed away - so all sorts of insurance claims started bouncing back "not covered". It took me a year and a half to get in touch with someone at the insurance company who said "oh my. you poor dear. let me fix this" and she had it corrected in less than five minutes.. but for that 18 months I had to deal with almost-monthly bills coming in with her name on them...

Im curious how would they know all medical indication show they could have survived longer. I mean I see few movies with this underline story but do we really have some solid proof?

this is true. Take 10 million couples and maybe 1 in 10 million, this happens, and this is what we hear in the news.

We never hear about the wife that lives 10 more years after their 85+ year old husband dies.

I’ve thought the same thing about stories of South Korean gamers dying from marathon gaming sessions.

If a millions people have marathon gaming sessions day in and day out, doesn’t it only make sense that one of them will die in their chair once in awhile? Was gaming really the cause?

Those cases are often Deep Vein Thrombosis[1] caused by not moving around enough.

https://en.m.wikipedia.org/wiki/Deep_vein_thrombosis

Problem is, I cannot take a single person and perform such test yet 10 million thats why I was looking for some solid stats or research/paper.

Maybe you don't hear. My grandparents were together since about 16 and my grandmother passed away 12 years ago. And I never seen couple more in love, including my grandma having tatoo of his name on her chest, something unheard of and frown upon back in the days. And my grandfather is turning 94 this summer.

Should be relatively easy to crunch those numbers - is there a significant reduced life expectancy for surviving widows/widowers?

I'd be surprised if this hasn't been tested.

For the longest time (and well, still to this day) I hated coming home to an empty house. I wanted human companionship - a hug, someone to care, someone to ask how my day went.

I had two cats, but they've since passed, and even before that it wasn't the same.

It's been almost ten years, and there's not a few days that go by without me thinking that nobody would miss me if I decided to join her.

It's tough. But life has to go on. My wife of forty years died of cancer last August after two years of treatment. Even though we both knew it would happen sometime we were neither of us prepared for it when it happened. Six months later 'I’m unmanned and unmoored without her' as the other commenter said. Half my memory is gone, I have no one to whom I can make all those scurrilous comments about friends and relations. No one's hand to hold while going for a walk. No one to hold and to touch.

But I have other people who rely on me, my children, my sister, the company I work for. So even though I am in tears as I write this, I know that I have to cope, I have to find a way to be.

It's going to take a while.

It took me about two years before the "fog" lifted and I started to feel again. Before I was doing anything other than going to work like an automation just to pay bills.

May I ask absolutely sincerely: how differently do you feel about the scenario of your wife suddenly leaving you?

Dude.

This thread is about loss. What I referred to can be an extremely acute form of loss. There may be people in this thread struggling to deal with the form of loss I referred to.

I agree it's important. Divorcees don't get smothered with caring like widow(er)s do despite how devastating it can be. Perhaps worse because not only have you lost them but they're also telling you you're not wanted.

No need for a hypothetical scenario in my case. It sucks, greatly, but I imagine pales in comparison to having a loving wife suddenly die.

When you have a divorce, separation, etc - the person is still there, still alive, around, may or may not communicate with you, etc. You can know that they're OK, even if they had to find happiness with someone else or whatever happened.

I was working late to make up some time and had headphones on. Wife told me "I'm gonna go soak in the tub and go to bed, see you in a bit." A couple hours later I finished what I was doing and headed towards the bedroom. I noticed the bathroom light was still on, and found her. Apparent heart attack and she drowned in the bathtub, and she'd been gone a while by the time I found her. Sudden wrenching loss. No opportunity to make up for fights. No goodbye. Just.. gone.

Anyway. This isn't about me. This is about the community helping Matt, in whatever way we can.

Reply on news.ycombinator.com