A couple of years ago, a photo of a doctor outside a hospital crying after losing his 19-year-old patient hit a nerve, and ended up being shared hundreds of thousands of times on social media. The photo captured one raw reality of working in medicine, which is that patients die, and it’s not always possible to respond with the stoicism that is expected of doctors.
Dealing with death is a fundamental part of being a doctor, and most doctors intuitively understand the need in professional life for a balance between compassion and maintaining a certain emotional distance.
But sometimes they will find themselves profoundly affected by a death, possibly of a patient they had known for a long time or with whom they had a special rapport. In these circumstances, the patient death can provoke feelings of helplessness, guilt or failure.
An added stress for doctors in some cases may be the worry of a complaint or even legal action from the family of the deceased.
Research seems to suggest that doctors are not especially good at coping with feelings of grief about patient death, nor do they receive adequate training for this. More worrying still, there is evidence that poor coping with patient death affects doctors’ ability to treat their other patients.
A recent study of 20 Canadian oncologists reported that more than half struggled with feelings of failure and self-doubt after a patient death, and felt their grief could affect their treatment decisions with subsequent patients.
Losing patients also affected their ability to talk about end-of-life issues with patients and families. Half of the participants reported distancing themselves from their patients as the patient got closer to dying.
The study suggested that grief in medicine is still considered shameful and unprofessional, and that even when doctors struggle with their feelings of grief, their instinct is to hide them from their colleagues.
Here are some tips to dealing with the death of a patient:
- Be completely honest with the patient’s family, and with yourself, about what’s happened;
- Convey empathy to the family and share their feelings of loss, if they are open to it;
- Discuss the case with your colleagues;
- See your GP if you feel a patient death is unduly affecting your professional or domestic life;
- Accept that negative outcomes will happen in your professional life;
- Accept that grieving is natural, even in the context of the doctor-patient relationship.
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