Patient care in medical school involves two sides of a coin: recovery or decline of the patient’s health. While most discuss the role providers have in healing and treating our patients, death and dying is not really discussed too much, despite it being something we will face often. Death can be hard to process so I wanted to share my own experience with it so far on this platform.
Two weeks into my surgery rotation I was faced with my first patient death in medical school. The patient died on the table not long after being given anesthesia for an exploratory laparotomy. I felt helpless during the code and as the doctors moved on to the next patient, I was still trying to come to terms with what had just happened. The surgeons didn't really discuss it, and so I quietly moved on to our next task and kept my thoughts and sadness to myself.
Yesterday on my OB/GYN rotation we had multiple patients who had miscarried and delivered. I didn't quite know how to handle myself because I wanted to cry but I also wanted to maintain professionalism and not take away from what the patient was experiencing. The doctor I worked with was so reassuring and it seemed like she knew exactly what to say. I took her lead but mostly stayed quiet for fear of saying the wrong thing. Afterwords, she asked me how I was doing. She told me that while all our focus is on the patient and their grief, it also takes a toll on us as providers in ways that people don't usually acknowledge. She said that overtime each loss gets easier to handle. I really appreciated her kindness and willingness to address what had happened instead of brushing it under the rug. We took the time to talk about it and discussed how it is important to learn how to appropriately deal with a patient's death.
Many medical students may not be fully prepared for the impact of losing a patient so I wanted to share some some coping strategies I learned about:
Empathize with the patients family through comforting words or a hug if appropriate
Seek counseling and support services
Express how you feel either through crying or journaling later, whatever it is that helps you to process
Prioritize self care to offload emotional stress that could lead to burnout and compassion fatigue (I will be making a separate post about compassion fatigue later)
Unhealthy coping mechanisms are also important to look out for. These can include becoming numb, suppressing our emotions, internalizing, or turning to substances.
As I continue in my career and gain more independence and responsibility, I'm sure there will be even more emotions I will experience, like guilt or blame, wondering if I did the right thing or made any mistakes. But having an emotional response to death isn't a sign of weakness or incompetence. Though there is a standard to maintain professionalism, I think taking a moment to yourself is important.
There are great highs and great lows while studying medicine. Witnessing such lows is a good reminder that life is fleeting, so we should be thankful for the moments we have.
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