Doctors don’t have the luxury of grief


On a normal Tuesday, one of my fellow residents did the same things we all do. She woke up before sunrise, put her best face forward, came to work, saw patients quickly, wrote notes, said “good morning” to everyone at morning conference, saw more patients, wrote more notes, then went home. She said “good night” to her loved ones  —  her parents and siblings at home  —  and went to sleep. The following morning, she was found dead in her bed.

I was on nights when she died. That morning I had gone home, showered and was getting ready for my daytime slumber when I received an ominous phone call from a co-resident. Then, one text message after another. A buzz of panic in our hive. The news came like a weight we couldn’t swallow or even comprehend but had to pass on to one another. And in that way, everyone in our program  —  all the attendings, ancillary and nursing staff and anyone close to her  —  eventually came to know of her untimely and unexplained death.

The following, blurry days were a waking nightmare for all of us. As residents, as physicians, we don’t get the luxury of grieving. We still came to work. We still clocked in the for the 80-hour week. We went on pretending that we were okay  —  that we were the smart, capable, limitless doctors who patients and the health care system, expect us to be.

But we were not those doctors. We were friends unable to grieve over a sudden loss. We were sisters who felt our other half had been destroyed. We were parent-figures who watched, for years, a young doctor grow into something powerful. We were colleagues who were inspired by her attitude and her grace. We were juniors who hope to be like her one day. And when she died, the void in our hearts was crushing and violating. It was unlike anything we had prepared for.

We all had our moments. Breaking down in supply closets and empty hallways. Staring at computer screens and gripped our scrubs, fighting tears at the nursing station. Losing. Feeling confident one moment, then suddenly getting the wind knocked out. Nearly falling, nearly fainting. Hallucinating, seeing her in the hallways, or outside the hospital. Fearing every unanswered call meant the person on the other end had died. Not sleeping for days. Needing medication, needing therapy. And still somehow, fighting for patients, arguing with residents from other services, delivering babies, cutting open abdomens, removing body parts, running down to patients in the emergency room, counseling women through miscarriages, discussing terminal illness with families. All of this with a tornado inside of us.

When doctors hurt, the suffering is quiet. We don’t get to leave our work behind. We don’t get to fly home. We are supposed to be the ones with the answers, the ones who understand pain well enough to prevent it. We don’t get to cry, or be angry, or offended. We are the professionals who suppress our emotions so that others can present theirs. Faces in white coats with a smile, burning out. Dropping everything at home and sleeping without resting. Working meticulously, often leaving our internal processes sloppy and incomplete.

When doctors hurt, the best we can do is hurt together. I am grateful for my co-residents who have not been afraid to share how much pain they are in. The work that we do and the way we live our lives are inherently conflicting. However, the way we understand ourselves and our roles as providers need not be incomplete. Remembering our co-resident and sister, we can strive to be grateful for every day, and to not take those around us for granted.

When I came to work the other morning, the hospital was still sleeping and the hallways were empty and peaceful. A housekeeping lady was mopping the floor. After we exchanged “good mornings,” she looked up at me with a smile and said, “You’re in the right place.”

I turned the corner and cried.

Jenna T. Nakagawa is a resident physician who blogs at her self-titled site, Jenna T. Nakagawa.

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