I Lost My Baby Brother to Fentanyl

And I am grieving as appropriately as possible.

In Hospice, we have a term that we discuss among our care team. When a person’s loved one is about to die, or has just passed away we often say, “They are grieving appropriately”.

Basically, we are communicating between the nurse, chaplain, social worker, and physician, that this person, the one left behind, is exhibiting “normal” behavior for the death of a loved one.

In Hospice training, I learned that there were certain types of deaths and circumstances that lead to “complicated grief”. Some of the signs we look for in grieving individuals and family members to assess their risk for complicated grief include the loved one dying suddenly or traumatically, loss of a child, spouse, or partner, being estranged from the loved one prior to death, having experienced other deaths at an early age, having an existing mental health condition and/or past history of trauma, negative circumstances surrounding a death like failure to be present or arguments with family members.

My younger brother would have turned 46 in July this year. Instead, he died alone in an apartment after taking Xanax which had fentanyl in it. My brother was a functional alcoholic and had been taking pills for at least a decade. In 2017 we had a “falling out” when he embezzled money from the family business he worked at with my ex-husband. The situation was very painful, and he left the family business and went to a competitor who paid him for all the family business’s trade secrets and customers.

I know that people who have problems with pills and alcohol will do the unthinkable to be able to maintain their addictions. Understanding that he had (and refused to get help for) substance abuse issues, didn’t make any of the pain easier. As a family, we worked together and shared holidays and our combined children went back and forth between our homes and were not only close cousins but also friends. After my brother’s addiction problem led to this event, everyone felt the trauma of the situation. We all missed each other but we were picking sides and feeling all the pain of the event.

A few years later during Covid and after my divorce in 2020- after years of complete estrangement, my brother started to text me occasionally and we had a few phone calls. He was still working but was frequently low on money and would sometimes ask me or other family members for money.

He never acknowledged that he needed to go to rehab, although I would find him resources and encourage him. He always said he “was clean” and doing fine. I knew that was never the case. I also knew, after many years of trying this, that no one could do the work for him. Addiction doesn’t work that way.

If I could have taken him by the hand and drug him to an inpatient rehab, like I used to drag him to his kindergarten class when we were young, I would have. Sadly, I had talked to enough therapists and drug counselors to understand that I could not save him from himself. He had all the power and I had none.

I resigned myself to being “ok” with not hearing from my brother for months, not knowing if he was alive or doing well. In the back of my head, I always tried to remind myself that a call could come in at any moment. I thought this would prepare me for what I thought was inevitable. It hurt that I could talk to him on the phone, or text him, but I couldn’t tell him where my new house was because of his sometimes erratic drug behavior.

I believed that when and if that call came, that I knew I had done my best to help him. I thought I was prepared, and the truth is, I was not. No amount of mental preparation could save how I felt when I received this call.

In May, this past summer, his coworker had called for a welfare check on him because he had not shown up for work for a few days. They had found him in a neighboring town where he had evidently had a “girlfriend” who, at the time of his death was in jail. I know from the coroner that he had been there so long, that the exact time of death was difficult to assess. I cry when I imagine him dying alone. My only comfort is knowing he went into a deep sleep and just didn’t wake up.

I find myself, acknowledging that I did have to keep my distance and boundaries, but also wishing I had found a way to just see him and hug him one last time.

If I had taken that opportunity, I would not have pushed him to go get help or go to rehab again. I would have just memorized his face and listened to him speak and I would have given him the biggest, longest hug. My deepest regret is that I did not do this.

I recently had a very vivid dream, a few months after his death, where I dreamt my brother walked up to me, took some type of invisible film off of his entire body, and without any words at all, we hugged. In my dream, it was as if I actually felt him and I could smell him. I woke up remembering every detail and I felt such peace.

I do feel as if he has tried to comfort me from beyond. I was recently sent into a patients’ room in the ER department. I walked in, sent in by another nurse to just turn off a beeping machine and switch a bag of fluid, but I was struck by how lonely this patient appeared.

He was young, but very obese, dirty, and alone. He began talking to me about his dogs. I really didn’t have time to listen, but something told me I should. He began telling me all his dogs’ names such as Peanut and Pepper. He was describing to me all their distinct personalities, looks, and antics. I made myself stop messing with his IV pump and actively listened.

He teared up and told me his favorite dog had just recently died and that he was so sad. He wanted to show me a picture on his phone of this special dog. He showed me a beautiful brown lab with big, deep brown eyes and I noticed he was starting to cry.

I asked him what that dog’s name was and I felt so dizzy and stunned when he told me it was “William Thomas”. I also started to cry and had to explain to this stranger that I too, had just recently lost my brother whose name, strangely, was also “William Thomas” and we just stared at one other for a few minutes in complete silence. My ears were ringing and I was a little embarrassed but humbled. I had been sent to this man for a reason beyond my knowing. This was no accident.

I don’t dismiss synchronicities anymore in my life. Hospice has gifted me with a deep spirituality that I did not possess many years ago. My intuition and my desire to understand as much as possible about life/death has expanded and so has the amount of synchronistic events I witness. I am frequently aware now that I am surrounded by people, moments, and miracles that aren’t just by chance. I’ve seen it in my own life and I’ve witnessed it after being present in over 100 deaths in my patients’ homes in the past year.

This year at Thanksgiving, I will make William Thomas his derby pie that I always made just for him. I will drink a Stella beer in his honor. He never bought them because he said they were “too expensive”, but he knew I would buy them for him to enjoy.

I miss him every day, but somehow, I know through a lonely stranger, that my baby brother knows that I loved him so very much.