Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

3 Strategies For Responding to Your Patient’s Experience of Loss


Even if you don’t fully understand your patient’s experience of loss, you can always listen, honor feelings, and show compassion.

Last month I defended my dissertation. In addition to loading my slides and grabbing water, I lit a candle. I’d always assumed my father would attend my defense, but last year he died unexpectedly. I lit the candle to honor and hold space for him, even in his absence. It was an exciting day filled with emotions. All of the feelings you might expect—anxiety, excitement, joy—but also sadness. Many of the people watching the defense didn’t know about my loss or realize that my softened response to earning a doctoral degree was grief tempering my joy.



In trauma-informed care, we ground our thinking in an understanding of the context of the patient’s lived experience, asking what happened to someone instead of what is wrong with someone. An important aspect of understanding the context is thinking about potential trauma reminders. Our memories are linked inextricably to our senses—smells, tastes, sounds—any of these can conjure up feelings from the past. These reminders can cause the past to intrude into the present in unwanted ways. Some of the reminders are easy to identify, but some are hidden and hidden reminders are often about loss. These reminders may include anniversaries, birthdays, and empty places at the table. Like countless moments this past year, my big day was a hidden reminder of my loss, something an outside observer wouldn’t know about, but something I felt deeply.



Hidden reminders are an aspect of the pandemic that haven’t been discussed very much. We’ve all experienced losses this year and many go unacknowledged—missed weddings, funerals, birthdays, and graduations. Even if we push through and try to ignore the loss, the hidden reminder may still be there—an unworn outfit, a canceled ticket, a circled date unobserved on the calendar. Hidden reminders are tricky. They may be difficult for the outside observer to understand and we may not recognize what triggered the reminder. It can sneak up on us out of nowhere. You’ve probably observed hidden reminders coming up for your patients and colleagues this past year. You may have thought “What’s wrong with them? Why are they acting this way? Did I do something to upset them?”



Here are 3 strategies for responding to patients in a trauma-informed way:


1. Challenge yourself to think in terms of what happened, instead of what’s wrong.

Instead of thinking what’s wrong with this patient or what did I do wrong, recognize that something might have happened that you don’t know about. You don’t need to know what happened to respond with kindness and grace.


2. Meet patients where they are.

We all have ideas and expectations for how things should go or how someone should respond. Recognize when you’re bringing your expectations to interactions with patients. Let your expectations go and meet them where they are.


3. Honor feelings. 

Support people by listening, acknowledging, and honoring feelings. Honor your own feelings as well.


Whether we discuss it openly or not, we’ve all experienced losses this past year. We can’t predict when feelings of loss will surface. In all interactions, whether with patients, colleagues, trainees, friends, or family, start from a place of kindness and grace. We all need and deserve support.