Wednesday, September 11, 2013

Death

There is a common joke among physicians, "No one gets out of this life alive." This joke hints at the discomfort many physicians feel about death. Being a patient or a family member of a patient helps us to be better physicians. Because of going through the experience of suffering helps us to learn to be more empathetic. Unfortunately, too often, being a physician does not prepare us to be either patients or family of patients.

A few weeks ago a friend died after a brief illness. Because he had been relatively well until a few days earlier, it was unexpected. Even, once he was admitted, I was hopeful that he would recover. But as I was considering going to the hospital to visit, I learned that he had died. This death, like each other, reminds me of the deaths of my parents and my own mortality. And it is that personal connection that helps us to feel empathy for our patients.

As physicians, we must shield ourselves from becoming too connected since it would be difficult to continue to function if we become overwhelmed with grief. Rather, we must continue to be rational in the care of patients, rather than becoming lost in our own emotions. Otherwise we would not be able to be good physicians and provide the best care we can for our patients. But we must allow the human connection to be seen by the patient and their family. That human connection is empathy. A few tears (at least from a female physician, though I think this may play differently for a male physician in American culture) or a touch can help to convey that connection. I think this connection can help heal both the family and the physician.

During my last year of medical school, my mother died very unexpectedly while we were on vacation. It was very traumatic for me, but also helped me to become more empathetic.  I even had to learn again to shield myself, as I began to cry when I had to run a code a few months after her death. The emotions were still too raw. Fortunately, the patient was one who had no chance of survival, so my emotions did not alter the outcome. A couple years ago I wrote about my mother's death. Here is the link:  http://www.physicianspractice.com/work-life-balance/content/article/1462168/2041808 Even all these years later, it was a difficult and painful experience to write about since the emotions again resurfaced.

As physicians we see death far more often than the average person, yet we are affected in similar, human ways. Yet, we must both control our emotions and show our empathy. That is a very difficult balance, but one I hope more physicians strive to achieve.


3 comments:

  1. Very interesting. I always wondered, "Who heals the healer?" You might be interested in this: "Death—That's Life" http://www.thescreamonline.com/editorials/editorial4-3.html

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  2. So sorry for your loss, Margaret. Thank you for sharing these stories. I think you're right - experiences like these, while devastating (especially in your case with your mother), do make people better doctors. It's hard to be a patient/family member having life and death conversations with a doctor who appears to have absolutely no empathy.

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  3. I read the article "Death—That's Life" http://www.thescreamonline.com/editorials/editorial4-3.html. It is quite interesting.
    And your question is important. Healers do need to be healed. Colleagues and family may help, and so may working with patients and their families. It is important to recognize when one needs healing, because if one doesn't, problems arise in caring for other patients, behavioral issues or abusing oneself with drugs or alcohol. I recently read Danielle Ofri's book, "What Doctors Feel," and hope to review it soon here.

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