Whitney You, MD, stared at the baby girl lying on the warmer in the NICU.
"She wasn't alive anymore, and I just couldn't stop crying," she says. For the first and only time in her career, You, an assistant professor of obstetrics at Northwestern University's Feinberg School of Medicine, couldn't conduct her rounds.
Although she had lost babies before and the experience was invariably wrenching, this loss felt even more profound and personal. You had grown close to the family during the mother's high-risk pregnancy and had recently given birth herself. She understood the family's lost hopes and dreams and their tremendous pain. "A social worker came in and said, 'I think this is just too close to your heart right now,'" recalls You.
Society has words for people who lose their family members. They become widows and widowers and orphans. "But society doesn't talk about babies who die," You says. "There is no term for a parent who loses a child."
One might argue that there's a similar linguistic gap in describing the physician's experience of patient death.
As concerns about physician burnout mount, the experience of physician loss and grief is getting more attention. Experts say the research and resources are welcome and long overdue, but they're quick to point out: For physicians to heal, they have to take off their armor.
Detachment and Its Price
Most doctors say their medical training didn't prepare them to deal with patient loss.
"The mantra in medical school was, 'See one, do one, teach one.' That's how we were [taught to] approach procedures and dying as well," says Prateek Mendiratta, MD, an oncologist and assistant professor at Case Western Reserve University School of Medicine. "We watched attendings deal with dying and end-of-life discussions, and we had to learn to show up for work the next day."
Mendiratta's experience is far from unique. Doctors have long talked about the need for emotional boundaries in medicine. In a study of 20 Canadian oncologists conducted in 2010 and 2011, Leeat Granek, PhD, associate professor at York University's School of Health Policy and Management in Toronto, Canada, along with a team of researchers, found that physicians wrestled with feelings of grief but masked their emotions rather than appear weak or unprofessional.
However, that stoicism affords doctors far less protection than they think: More than half the participants in the study reported feelings of failure, self-doubt, sadness, and powerlessness, and a third reported feeling guilty, losing sleep, and crying.
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Cite this: Shelly Reese. Why Doctors Need to Mourn - Medscape - Jul 17, 2019.