Coping with Loss
Written by Puja Singh, MD
“Never get too close to your patients”
“Back to work”
“Time of death”
…
These are often phrases we hear. No one teaches us how to cope with our grief. No one teaches in medical school that it is okay to be sad and cry when we lose a patient. It is okay to hold your patient’s hand in their time of need. We are human and have emotions associated with our job. I think we, as a medical field, need to do a better job normalizing this.
Starting residency can be hard for so many different reasons: a new environment, a new job, new coworkers, a new hospital system, etc. Supporting your patient and their family members in their time of need is also part of our job. Being human - and then reacting to a poor outcome.
How do I cope with this?
A moment of silence- After losing any patient, I take a moment of silence. Most of the time, an attending or senior resident will initiate this for the room. However, if that is not the case, I will initiate a moment of silence for the patient that we lost.
Giving the family and loved ones a space to grieve- After any loss, I put myself in the position of the family. If that means clearing up a room, cleaning off any medical supplies, tidying up the area a bit, and covering your patient with blankets and sheets, then do so.
A phrase that is to the point and meaningful to share with the patient’s loved ones- Coming up with a phrase of 1-3 sentences to say after each loss was important for me. A few examples are- “I am so sorry for your loss”, “You could not have done anything”, “You were so brave”, and “We did everything possible to save your loved one”.
Do not be embarrassed by your feelings- For the first half of my intern year, I would always be embarrassed as my eyes welled up in tears after a code, during palliative extubation, diagnosing someone with end-stage disease, or after calling time of death. However, I soon realized that was my way of grieving. I am human and there is nothing to be embarrassed about. Taking a second to go to the bathroom or your resident lounge to take a moment for yourself is normal. As an emergency medicine resident, it is expected of me to be ready for the next patient, and these moments to take deep breaths and cry were my way of recharging. Validate your feelings and your grief. Take care of yourself, be self-aware of what you need, and don't be embarrassed for having feelings and being human. I think it makes me a better physician, and most definitely a better person.
Talk to someone and reflect- whether it is family, a friend, significant other, or obtain professional help. It is important to process our feelings and thoughts promptly. This can come in many different forms. I love to journal. Sometimes, when I do not feel like saying things out loud, I will write them down. This has helped me find solace. Talk to your co-residents, share stories, debrief and reflect. If you need some time off, reach out to your program administrators. The truth is, if you are not at your best, you cannot help anyone else. It’s like how they say on a plane, “put your oxygen mask on first, before helping another”.
These are just a few methods I use to cope with a patient's loss. It never gets easier and hurts every time. Remember that you had an impact on this person and their family. You share a piece of them and their life, and that is a joy and an honor.
