Life after grief 

The memories come back to me in bits and pieces. The cry of a father after I called time of death, the shock on a mother’s face as her daughter quickly clinically decompensated, the heaviness in my chest as I held a dying baby boy for his parents, the tears of a young boy being comforted by his mother as he lost his big brother, the quiver in my voice as I call a family with preliminary autopsy results. In medicine, some would say we are called to duty of care, of healing.  

How do we hold ourselves up when we guide patients and families through death?  

Many people in the U.S., healthcare professionals included, shy away from honoring, discussing and facing death. In pediatrics, even more so. In the shadows of these losses, I’ve faced anxiety and even loneliness. Did I do what was best? Should I have done more? Did I support and honor their goals and wishes enough? I don’t know that I will ever really know.  

What I do know is that it’s the hug from the social worker who witnessed the same code event, the thank you from parents who just lost their child, and the support of my team that continuously fuels my resiliency. We can be present and listen. We can bear witness to the unspeakable.  

As for the loved ones, are they ok?  

I recently had the unique experience of being invited to a baby shower to celebrate the arrival of a sister to a baby boy who had died in my care. This came at the end of a week that I had to hand over the dead body of a beloved two-year-old to her mother less than six hours after arriving to the ICU. I hesitated to accept the invitation. Were they sure when they invited me? Would I bring back bad memories? Would it be traumatic to see me? Would it interrupt the joy of celebrating this new baby? 

So, what’s the answer? They are never ok. They are forever grieving. I didn’t ruin the celebration. Two years had passed but my body didn’t forget. My autonomic nervous system was in full gear. I was sweaty, tachycardic, and flushed. The parents caught me up on their life, shared the jewelry they had made from ashes, and hugged me while proudly introducing me as the doctor who had so lovingly cared for their son at the end of his life. It taught me that beyond sadness, there can be hope and joy. Honor the duty of care in health and in death, you never know how much of a difference you can make.  

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.