I have been avoiding writing this post because although it’s something that has been on my mind for a long time, it is incredible painful to think about. I knew when I became a doctor that bad outcomes and death would be a part of the job. I knew that there would be patients that do well and patients that don’t. I don’t know why I did not think about what that would do to me as a person.
These past two weeks have been hard on me, so I thought it was about time I wrote about it.
One of the biggest drives for most of us that become doctors is to help people, to fix problems, to give hope, and to be part of the journey that our patients and their families go through. I can’t speak for every or most physicians but I know I have discussed these feelings with a lot of my doctor friends and we all have similar reasons behind our career choice.
When something is wrong, my first instinct is to make it right. No matter what the “something” is. As a doctor, all I want to do is to take away my patients’ disease and any complications associated with them or the treatments I give them.
In the last two weeks, two of my patients seemed to have a bad reaction to a medication I prescribed. One of them did well and perhaps had that reaction unrelated to the medication but the other patient didn’t. He could have had some really bad outcomes but luckily, family brought him to the ED and he was admitted and eventually discharged home. Later in the week, someone I consulted on via phone passed away in an ICU across the globe.
It is hard when these things happen not to blame yourself as your first thought. I usually quickly run through all the objective points of why it isn’t my fault but the guilt and sadness is hard to shake off.
I know that the side effects of the medications were discussed with the patients and their families. I know there is a chance that patients will experience the bad side effects. I know that sick patients die, even after you do everything you can for them, and that most of the time it is no ones fault. I even believe the words I say when I talk to my colleagues about their experiences and how it is not their fault, but I am not sure why it is so hard to believe them when it happens to me.
When a patient dies, even if you know there was nothing differently you could have done, there is a whole other layer of difficulty in coping with their death. We don’t really get trained on this in medical school. There are often debriefings for residents and I even heard about a support group at my job, but these meetings are hard to attend when you have a busy schedule and are not really enough.
My biggest problem is that I often feel like it is not my place to feel sad. It is not my child or my family member, so why should I feel grief? Why would I need to cancel my next patient or take off a day when a patient died when there is a parent who just lost their child out there?
A non-medical friend recently told me that I am allowed to feel whatever I feel. It seems obvious but I always fought any feelings of sadness or grief when a patient died, so I could keep going through my shift, my day, my week. I don’t want to do that anymore.
I have not found a solution or a great way to cope. Most of my patients and their families know that I treat every child as if they were my own, so their failures and negative outcomes affect me deeply. My first step in dealing with grief is to allow myself to feel whatever I need to feel. To allow myself that time off, the time to cry, the time to reach out to the family, or do whatever I need to do to get closure. If anyone has ways in which they cope with their grief, please comment and share these with me.
Today was a sad day for all after hearing the passing of Kobe Bryant, his daughter and her friend as well as her parents. I hope everyone allows themselves to feel whatever they need to feel before starting the new week.