I'm a doctor and I’ve been treating dying people and their families for over 40 years. I thought I knew what grief was and what dying was. I didn’t.
I was the psychiatric consultant to the bone marrow transplant unit at the University of Minnesota from 1978 to 1982. It was a novel treatment, offering hope at that time, but not the miracle it is today. Unfortunately, the mortality rate for this treatment was high and I was there to help patients through life and death.
We physicians are trained to accept death as a part of life and illnesses, and to help others and their loved ones challenged by the process. Each one requires a review from us and time to place it in the notebook of experiences we have encountered and learned from. Sometimes, and particularly more recently with the COVID-19 challenges, we may not have time to process and learn from them, but rather just focus on getting by, and making it to the next case or situation. In this process of “Cumulative Grief”, we don’t have time to integrate the impact of what we have witnessed or experienced, to learn from it, and are struggling with emotions we didn’t notice before (or that we unconsciously adjusted to)–even though we’ve been trained to press on through it all.
Georgetown Psychology describes Cumulative Grief as “what happens when you do not have time to process one loss before incurring another. The losses come in too rapid a succession for you, the bereaved, to heal from the initial loss.” As the losses compound, processing each one becomes harder. Even being in medicine, you shouldn’t be accustomed to or able to perfectly process cumulative grief.
The personal lends to the professional
My wife died last year after a year of cancer–she rolled with the diagnosis; surgery; COVID restrictions; complications; treatments; terrible tumor effects and dying. I tried to help in whatever way I could, while letting her make choices and asking for my help when she wished it. I watched her take her last breath and surrounded her with the people she wanted with her. I did whatever she wished for her memorial. She left me with two predictions: “You’re going to miss me” and “I’ll be watching you.”
Yet, through all of these experiences, I still don’t know what it is like to die. But I do know grief in a personal way at this point. Feelings of sadness, disbelief, feeling stuck… pulling into the turtle shell. Letting a few people into my life reluctantly, trying to let my adult children help me–as they are successful and loving people who just lost their mother; rethinking God. Imagine all these personal feelings swirling about, and then piling multiple professional losses on-top of those feelings. They don’t all have to be personal, but grief that accumulates must be addressed.
I’m overwhelmingly thankful to be still an active psychiatrist and involved with the unpacking and addressing the issues in the lives of others. I don’t know what I’d do without that. A person can only read so much; exercise so much or try to be involved with others so much.
The best advice–and the most acceptable advice to me personally–has come from others who have been through it like Rabbi Kushner, a best-seller author who wrote When Bad Things Happen to Good People; author Joan Didion, famed for her depictions of American life and personal journalism; my family, my friends and my neighbors. All had their own process and timeline for healing and acceptance but the timeline was hard to accept–months and years maybe but definitely not days or weeks.
Personal loss can help one be more empathic, maybe even be a better doctor. Professional loss of patients can too, but both may require a guide to identify unwanted feelings, changes in behaviors and to forge a new path of learning, acceptance and healing. In other words, treating the grief. Letting someone treat us. Even losses short of death like illnesses, job changes, income changes to name a few, can initiate an unwanted grieving process. Asking for help as a physician can be a strange reversal of roles. VITAL WorkLife has life-changing resources like Physician Peer coaching and counseling to help us healers heal and become better in our professions in the process.
In your grief you feel so special, so singled out. Everyone dies but your loss, or losses, are so different. The world is quiet–no meaningless conversation, no daily plans, no talk of the future, no discussion of the family, health, friends, the ones you love. Just quiet. You look for the signs in the wind, the moon, the sun, the trees, the birds. And maybe something that hits your emotions and sets you crying–or smiling–but mostly it’s quiet. You’re reluctant to disturb your world, your clothing, your cards, your possessions–stuff.
Everyone dies, every death is special, and although our pain is unique to us personally, we can heal from it, be enriched from the painful experience and be more helpful to others than we once were. We are all reluctant to enter into this role but reading VITAL WorkLife’s article on “Physicians and the Stigma of Seeking Help” can help reduce some of your automatic barriers.
We Can Help
Grief is a normal part of the human experience, but if you feel like grieving is a burden or too overwhelming to process VITAL WorkLife is here to help. Your Physician Well-Being Resources include counseling and coaching, available for you or your family members to utilize. Contact us at 877.731.3949, through the VITAL WorkLife App or contact us online.