I didn’t know
when I placed my stethoscope on your chest,
listening,
that I was listening for the last time.
I didn’t know
that you said,
“when the doctor sees me, I will be fine.”
I wish I had held you longer.
If I had known it would be the last time,
I would have listened
to your heart
for a few more minutes.
I am sorry you had to go
too soon.
It still hurts so much when I lose,
and death steals
my patient.
Over the last forty-five years of my career in medicine, there have been mostly wins, joyful moments, births, and cures. I have witnessed my patients getting married, their children growing up, and experienced the happiness of enabling lives with better quality. This truly is the best job I could have hoped for.
However, what do I do with my losses? Those who, despite our best efforts, die. As a clinician, I need to go from the bedside of my dying patient to the next one, with all my positive energy, a smile, and complete focus. And yes, we do this because we can compartmentalize. We box away the sadness and grief at losing a patient, sometimes even those who become like family. Over the years, I get to know so much about my patients, how their spouse treats them, how badly or well their children are behaving, what stresses them, and what makes them happy. We talk about holidays, books, and art. Some of them give me investment advice or predict political outcomes. These are people I am invested in and interested in. And then one day, death steals away one of them.
These days, some hospitals, especially ICU units in children’s hospitals, have “grief rounds” where the care team of the deceased person can express their emotions. We don’t know what the long-term repercussions are for physicians for this unexpressed grief and emotion at losing patients. Is it bad to develop a defensive armor? Is it bad to care so much that we will be incapable of taking care of our next patient? Should we not address the trauma that physicians go through in a lifetime of losing their patients? Studies have shown that younger physicians and female physicians suffer more from the emotional aspects of death among their patients. We need to talk about this. How can we be empathetic and humane and be expected to walk away from the deathbed and have a bright smile walking into the room of the next patient?
Humeira Badsha is a rheumatologist.
