I’ve been thinking about this over the last ten and a half years since my soul mate had a cardiac arrest and died. He was 38 and as fit as a fiddle. I am a rural general practitioner in South Australia (family practitioner in American parlance). He left behind four kids (from his previous relationship), and me with a broken heart. We had been together a little over two years.
Western society doesn’t talk much about grief. Doctors are not much different when it comes to discussing personal experience, but there are a few things I have figured over the last ten years.
1. Most doctors know death more intimately than the general population. Some of us meet him quite regularly. While some patients’ deaths tug a little more strongly at the heartstrings, we are mostly pretty good at maintaining “professional distance.” We “hmm” and “ah” and convey genuine care and connection, but then walk out the door and start fresh with the next patient. The more we do it, the better we become at it. Knowing death so intimately may falsely lead us to think we are acquainted with grief but when it comes to losing a loved one, all bets are off. The professional veneer is possibly an impediment to leaning into the experience of grief, as our usual relationship with death is geared to be disengaged from any emotional buy-in.
2. Doctors understand the limitations of modern medicine and the fickleness of life better than the general population. We know that not everything can be explained or understood. We know that sometimes bad stuff just happens with there being no reason, nothing to blame. I’m not entirely sure if this depth of knowledge helps or hinders the grieving process or simply means that the collection of jumbled thoughts around it may just have different themes for a medico compared to others.
3. Doctors are often high-achievers, driven, control-freaks. Crass generalizations I know, but often true nonetheless. This personality trait is not limited to the medical profession but does add a complexity to grief when it so clearly reflects an event totally out of our control.
4. Doctors spend most of their time observing. We might seem present in the moment but possibly in a disassociated way- watching from above rather than fully engaged in the moment. We are constantly on the lookout for transference, counter-transference, double guessing what a legal opinion might think of a management approach, running through mental lists of differential diagnoses. There but not there. This is not generally a useful skill in personal grief. Grief is a reflection of the depth of our love for that lost. Unless we have loved in a dispassionate, dissociated way, we do not give our grief a fair chance if we do not live it.
5. Acute grief is painful, distressing, heart-wrenching. Having lived it and survived the early intense days, we will actively do our best to avoid revisiting the intensity of those feelings. For many, the idea of trying to recount details of such events is too painful to contemplate, though for some it is a very therapeutic pastime.
6. Doctors are masters of hiding our emotions, which is a useful skill in some consultations. A patient may have revealed an embarrassing event, or confessed a particularly bizarre past-time and keeping a straight face is the most polite option rather than expressing slack-jawed incredulity. Many doctors would be horrified at the thought of actively sharing a personal anecdote with a patient, let alone in public, and some teaching would admonish a practitioner blurring the doctor-patient lines of relationship in such a way.
When Mick died, I wanted to connect with another story in some way similar to my own, and I identified grieving-as-a-doctor as an important aspect of this. (As well as sudden death, living in a small community, being relatively young, being a bereaved kind-of step-mother.) I found very little in the way of doctors’ writing and reflecting on their own personal story of grief.
Assuming I am not alone in my wish to seek comfort in hearing others’ stories, I am collecting blog posts, my own reflections and contributed stories and would value input from any doctor or health professional willing to share their thoughts, anonymously or identified.
I firmly believe there is no right way to grieve and what works for one person may be wrong for the next. I do think the more stories available, the more chance of finding one that rings true for another grieving colleague, who might otherwise feel an additional sense of isolation and lack of shared understanding that can only come from someone else who has walked the path.
Alison Edwards is a physician in Australia. She blogs at docgrief and can be reached on Twitter @doc_grief.
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