Bearing Witness to Grief

To the Editor: Physicians-in-training are not immune to grief. During my (E.L.) second year of medical school, my uncle was diagnosed with metastatic pancreatic cancer. Upon hearing the news, I immediately began grieving his death, aware of his grave prognosis. My uncle died within 3 months of his diagnosis. I was on my surgical rotation and unable to attend his funeral. One year later, on the first day of my family medicine subinternship, one of the patients on the service died from metastatic pancreatic cancer, and I felt the wound of my uncle’s death reopen. We suspended rounds momentarily, and the resident who had been caring for him stepped aside to a vacant window to cry. I had never seen a physician express emotion over a patient’s death and was surprised at the profound impact that this patient had made on her. Watching this resident grieve, I began to wonder what sorts of spaces are available for medical trainees to express our grief and talk about the suffering we witness. The professional culture of medicine often demands that we set aside our grief and suffering (and that of our colleagues) to maintain professional boundaries. As medical students, we begin grappling with establishing these boundaries early on, attuned to the tension between being empathetic and being overly impacted by our patients. I had always wanted to be the kind of physician who is not afraid to be impacted by emotionally difficult cases. Yet I began to recognize how I had intellectualized my own uncle’s diagnosis and death and how a demanding schedule had kept me from attending to my own grief. I recognized how my unaddressed grief was, in part, influenced by this informal curriculum of medical culture, and it could impact my future role as physician. When we fail to allow grief to occur in the hospital workplace, we become burned out and less able to care for ourselves and our patients. Death and dying are ubiquitous in medicine. Therefore, it is imperative to teach medical trainees how to acknowledge and attend to our own grief. After that patient’s death, as a team, we were able to acknowledge and address its impact on all of us through a team debrief. It is through such conversations about difficult clinical scenarios and personal struggles that we can grow as future physicians and learn to better cope with the immense loss and suffering we bear witness to in medicine.

Aside · Family medicine · Feeling · Grief · Psychiatry · Traumatic grief · Witness · Wonder · Empathy and Medical Education · Law · Medicine · Palliative Care and End-of-Life Issues · Psychology · Social Psychology

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  Open Access•Lala L Forrest, Laura Blyton•Academic Medicine•2023

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