When a patient dies, sharing your emotions with trainees normalizes this response and highlights our shared humanity.
Lifelong Learning in Clinical Excellence | August 15, 2022 | 2 min read
By Daniel Saddawi-Konefka, MD, MBA, Massachusetts General Hospital
The man held his son’s broken body in his arms and screamed his son’s name over and over, followed each time by, “I love you so much.”
I was an ICU fellow on the team that coded his teenage son for close to an hour. He and his wife stood at the door of the ICU room hoping for a miracle that didn’t come. Their grief demolished me. His father’s screams lasted for over an hour. I remember feeling that there would be no consoling this man. As a new father at the time, I felt that trying to console him would be almost irreverent, stealing his grief for his son.
Right after the boy died, I went to care for my other patients. My team members kept their feelings about the tragedy under the surface. I felt gutted, but I followed suit. I didn’t really open up to anyone about it for weeks. It’s been years now, but even as I write this, the tears flow.
In medicine, inadequate emotional self-care is normalized. I think it comes from a good place, the notion of serving others above oneself. But it’s a false dichotomy—we can take exceptional care of patients and still care for ourselves.
Had I shared what I was feeling with my attending at the time, I have no doubt that I would have been met with empathy, shared tears, and a break from clinical responsibilities to catch my breath, all without any judgments attached. But that level of reflection and emotion sharing didn’t seem like the normal thing to do. After all, I’d never seen my clinical role models break down the way I think I would have.
If we want our trainees to process these traumas, we need to be better role models. Of course, everyone will process them differently—some in the moment, some a day or a week later, and some not at all. An important first step is to bring attention to these difficult moments and tell trainees that many (including their role models and mentors in medicine) experience these same feelings. We need to share with learners the devastation, guilt, shame, and grief we have faced.
I now serve as the program director of a residency. Every year I relate the story of this man and his son to my new residents, with no emotions held back. No matter how much I wish it, I cannot save my learners from similar wounds. But I can show them that it’s normal to hurt. My hope in sharing this vulnerability with trainees is that, when the time comes, their emotions will feel acceptable, and they’ll feel comfortable processing their feelings in whatever way is most helpful.
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.