Recently, a patient who was seriously (but not terminally) ill died unexpectedly. His family began crying and wailing loudly. Several nurses tried to comfort them, but their cries grew even more piercing. At one point, I offered to move them to a private area but they refused to leave the patient's bedside. All the patients in the unit could hear the commotion.

I've never seen this kind of mourning before. What could I have done differently?-D.A., DEL.

Nothing. There was nothing you could do but allow it, even if the lamentations disturbed others in the unit. We've mourned this way since the beginning of human history. It's normal and right to do so.

Recently, I was asked to see a woman named Nancy who'd been newly diagnosed with an aggressive lung cancer. When I entered the room, her two daughters were perched on the bed in a way that sparked my memory. They'd sat in exactly the same fashion when I attended their dying dad 3 years earlier. Astounded at the not-so-joyous reunion, we all hugged.

Later, while Nancy was napping, one of her daughters told me how rapidly Nancy's condition had worsened in just a few weeks.

"Dr. Sloan says she'll probably die within 6 months so we need to think about hospice. I just can't believe it. I'm not ready for that!!"

Her sister nodded. "How can he even say that when he just made the diagnosis a few days ago? I don't think he knows anything for sure."

We talked awhile longer, then I excused myself to see other patients. When I returned later that afternoon, Nancy's condition had deteriorated dramatically. I called the pulmonologist, who examined her immediately and confirmed what I suspected-that she was dying.

The two young women hovered near their mother, crying and begging her "not to go." Administering morphine and oxygen, I kept Nancy as comfortable as possible. By sunset she was dead.

In unison, the young women began sobbing and wailing loudly. They moved aimlessly around the room, as if weaving a magical spell to revive their mother. They kissed her cheek to reawaken her. They protested to God to "give her back!!"

I simply stood near, as unobtrusively as possible. Their plaintive cries wrenched my heart.

And then, after only 10 minutes, they grabbed their cell phones and called their husbands. Pleas to God gave way to practical concerns.

"Call Pastor Hubble."

"Pick up the kids at Karen's."

"Let Roger know that mother died."

I would not, could not, have suppressed their lamentations. Nor would I have allowed anyone else to do so, even though I'm sure other patients heard the cries. Perhaps they silently wondered if their own death would affect someone as deeply.

Mourning behavior and rituals vary widely for both cultural and personal reasons. At a moment of intense grief, stepping back and allowing families to mourn in their own way is the best nursing care you can give.