I know how they did it
The parents of Conan O’Brien, the late-night host and comedian, died this week — within three days of one another.
Conan, the third of six children, grew up with busy, working parents. His father, Thomas Francis O’Brien, 95, was an epidemiologist at Harvard’s Brigham and Women’s Hospital in Boston, specializing in the field of antibiotic-resistant bacteria. Conan’s mother, Ruth Reardon O’Brien, 92, was one of only four women in her law school class at Yale and just the second female partner at the Boston-based firm Ropes and Gray.
Ruth left her career briefly to care for her children but returned to work in the early 1970s. She retired in 1996, about 25 years later. In a video he made about his mom’s career, Conan recalled that when she made partner, it was “pretty emotional, pretty amazing.” Thomas retired just a few years ago at the age of 90.
Conan has spoken affectionately of his childhood home. “There were six kids, two dogs, a cat, my grandmother, a parakeet,” he said in the video, calling it “lovely madness, but madness still the same.” He added, “I don’t know how they worked it out, but they worked it out pretty well. We’re all here, we’re all alive. I don’t know how they did it.”
The widowhood effect is the increased probability of a person dying shortly after a long-time spouse has died. An NIH study of 370,000 elderly married couples published in 2008 found that within the first three months after one spouse dies, the excess mortality rate for the surviving spouse increases between 30 and 90 percent. For men, the death of a wife was correlated with an 18% increase in mortality, while for women, the death of a husband was correlated with a 16% increase in mortality. The study’s authors described their findings as “one of the best documented examples of the effect of social relations on health.”
But correlation is not causation. There are many reasons that people may die around the same time as their spouse. In addition to sharing their lives, couples share risk factors associated with lifestyle including environmental and economic conditions. Couples are likely to have similar habits of diet and exercise, patterns of substance use and abuse, socioeconomic conditions, and exposure to pollutants and other toxins. These shared circumstances may be enough to explain the occurrence of concomitant death.
Takotsubo syndrome (TTS), or “broken heart syndrome,” is different. A documented clinical diagnosis, TTS is an acute type of heart failure known as stress cardiomyopathy. Long misunderstood, TTS is now associated with increased morbidity and mortality. Perhaps not a direct cause of death, but an observed phenomenon, nonetheless.
Other than age, there are no strong predispositions for TTS. While it is significantly more common in women, it’s not a gender-related condition. TTS represents almost 2% of cases of acute coronary failure and is usually linked to a significant physical or emotional stressor. This connection between the heart and the brain is evidenced by critically high levels of catecholamines, or stress hormones, like dopamine and adrenaline, and is recognized as a fundamental part of the syndrome. We used to refer to this as “dying of a broken heart.” Now we have a medical explanation.
When I met my wife, we weren’t especially young, but in retrospect, we were just babies. We were old enough to know that dating was no longer just for fun. We both wanted marriage and children. And we knew broadly what we wanted a lifelong relationship to look like.
Stephanie and I met at a party and had matching crushes right off the bat. The party was hosted by a friend of mine who had gone to college with a friend of Stephanie’s. In my four years of living in New Haven, I had never formed any kind of real relationship with a student. And in her three years of medical school, Stephanie had probably had even less experience crossing the town-gown divide. But from the time that Evan encouraged Stephanie to join him at his friend’s party, and then later that night, to get up off the couch, walk across the room and introduce herself, we have barely been apart.
When Stephanie decided to move to New York for her residency, I told her I couldn’t leave New Haven unless we were engaged. It wasn’t the first time that I nudged her to take big steps with me. I was the one who first announced, I’m ready for a baby. I was the one who pushed us to purchase our apartment. But Stephanie has provided an equally steady hand and supportive confidence when we needed it. Despite my persistent declarations of wanting three children, when the time came to have a third, I was terrified. She was the one who ultimately made the call, and she was the one who reassured me for the entire pregnancy that everything would be alright.
It wasn’t always easy. Stephanie’s job was stressful, both in terms of her quiet ambition, from being chief resident to becoming full professor, but also in the daily pressures of caring for the sickest moms and the riskiest pregnancies. She also felt the financial pressure of being the higher earner for many years.
My job in the public sector gave us the flexibility and the stability we needed to be present, working parents. Stephanie was out of the apartment at the crack of dawn, and I would get the kids ready for school. To the extent she had any control over her schedule, she would use her post-call days to attend holiday potlucks and classroom birthdays, regardless of how tired she was. Most days, Stephanie was home before me, but it was my job to stop at the market and get family dinner on the table.
Egalitarian marriages aren’t easy. No matter how much your feminist wife might think that’s what she wants, she also wants to be taken care of. And of course, all these feelings, which we repeatedly denied were rooted in any kind of resentment, led to fights, sometimes bitter and sometimes ugly, usually about something other than the actual underlying issue. We had both seen our parents fight, so we knew how to do it.
I could get very angry, lose my temper, and feel genuinely hurt, but no one could execute the silent treatment like my wife. I think our record was three days without speaking. I was usually the one who caved, capitulating to apologize. I really didn’t like the silent treatment; it played right into my deepest insecurities.
But life got easier. The kids got older. Our financial security improved. And we somehow came to the realization that the fighting wasn’t worth it. It just wasn’t how we wanted to live.
We’ve made decisions about money, religion, children, and careers together. And I know we have more big decisions ahead of us, decisions about money, retirement, healthcare. For us, making the big decisions has never really been all that hard. It was the small decisions that triggered big feelings. In fact, I honestly can’t even remember what our bitterest fights were even about.
Looking back over the past 33 years, I can see that we’ve grown up together. I’m simply a better person than I was when we met. I’m more mature, more empathetic, more self-aware. I’ve had the benefit of seeing myself through someone else’s eyes. Someone who knows I’m not perfect but still needs me to be the best that I can be. She’s the last person I ever want to disappoint.
I didn’t know the O’Brien’s. I don’t really know anything about their marriage, and I certainly can’t presume to know Ruth’s cause of death. Even if I had known them, it’s never possible to know what’s going on inside someone else’s relationship. That’s been proven too many times. Divorces that seem to come out of nowhere. Allegations that seem too shocking to believe.
But I can imagine that, when you get to the end of a 66-year marriage, it’s got to hurt. All that love, all those hopes, all that joy and all that pain, all those accomplishments behind you. Your brain says to your heart, What are we gonna do now? And your heart responds, I don’t know.
Conan said about his parents, “I don’t know how they did it.” I actually think I have a pretty good idea how they did it.
