Doctors Carrying Grief — Interviews with 20 Oncologists — Dealing with a Continual Stream of Death Is Tough

© 2012 Peter Free

 

24 May 2012

 

 

We all know that some people hold up better under emotional adversity than others — medicine is not different

 

During medical training, I concluded that pediatrics and oncology held a higher proportion of admirable souls than other medical specialties.  Arrogance was noticeably diminished, empathy elevated.

 

I suspected that children’s innocent concreteness keep pediatricians “real” and a stream of death keeps oncologists humble.

 

But there are risks in emotional openness and soul-to-soul connectivity.

 

The Archives of Internal Medicine very recently published a very small survey directed at finding out how cancer physicians cope with the sadness of continually losing patients.

 

 

Citation

 

Leeat Granek, Richard Tozer, Paolo Mazzotta, and Aliya Ramjaun, Nature and Impact of Grief Over Patient Loss on Oncologists' Personal and Professional Lives, Archives of Internal Medicine, doi:10.1001/archinternmed.2012.1426 (online first, 21 May 2012)

 

 

A few quotes from this article sum the specialty

 

The authors spoke to 20 Canadian oncologists.  They concluded that psychological compartmentalization gets these doctors through.  The physicians said that dissociation and denial often characterized their emotional responses to serial death.

 

The survey incorporates an almost poetically constructed chart that includes 19 quotations, which reveal the burden oncologists carry each day.

 

Emotional distancing probably often accompanies feelings like these:

 

“Sometimes I’ll take a chart and I’ll look at the imaging, and everything’s worse and the numbers are worse, and I have to drag myself into the patient’s room and figure out what can I offer them that’s hopeful and positive. It’s tough.”

 

“You think you’re going to go in there to cure people . . . and it doesn’t happen. It doesn’t matter what you do really. . . . Sometimes I make an impact on what happens but sometimes I just get steamrolled.”

 

“I go through weeks where it’s very difficult to come into work. I come in and I don’t really want to be here at all. It’s an effort to drag myself down to clinic . . . because I know that I’m going to see patients who are going to do badly.”

 

© 2012 Leeat Granek, Richard Tozer, Paolo Mazzotta, and Aliya Ramjaun, Nature and Impact of Grief Over Patient Loss on Oncologists' Personal and Professional Lives, Archives of Internal Medicine, doi:10.1001/archinternmed.2012.1426 (online first, 21 May 2012)

 

This one oncologist’s conclusion synopsizes an admirable soul’s response:

 

“I’d say in the big scheme of things you do become a bit philosophical. . . . I think it probably straightens your need or want to be a good parent and to be a good friend and a good partner . . . because that’s where happiness really lies.”

 

 

The moral? — If we can remain open to the suffering that comes our way, we may eventually emphasize what is actually important

 

Oncology is a particularly demanding medical specialty because serial death punctures our illusory sense of continuity.  Death strikes repeatedly.  It laughs at our sense that we can fend it off.

 

I doubt that the average human psyche was constructed to deal successfully with daily or weekly reminders of its own (and loved ones’) mortality.

 

I admire oncologists, who continue to do what they can for us, without completely shutting down.