Desensitization

[Tawantinsuyu]

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As a physician, especially an ER or trauma doctor, do you become desensitized to death? For example, would it be normal for a doctor to have a patient die on them, but then go on and laugh about one of the nurses farting a few seconds later? Does death just become a routine thing?

 

[Pacna]

In my (limited) experience, nobody is really saddened much by an elderly death, but a young death in an ER can put everybody in a bad mood, even if they weren't directly involved in the person's care. When I witnessed that, seasoned docs turned inward and somber for at least a few hours.

 

[Chillbo Baggins]

 

[Straw Hat]

Yes there is desensitization otherwise you'd burn out. But as mentioned above, it's tough when someone young dies.

 

[sunflower18]

In my (limited) experience, nobody is really saddened much by an elderly death, but a young death in an ER can put everybody in a bad mood, even if they weren't directly involved in the person's care. When I witnessed that, seasoned docs turned inward and somber for at least a few hours.

This is my experience as well. Mechanism of death is also a big factor -- traumatic deaths seem to invoke more sadness and shock than medically related deaths, likely because the former are so sudden while the latter may have been slowly creeping up for a long time.

Death is hard, though. I think that it should always be hard to some extent. So while yes, desensitization is common (and somewhat necessary for the healthcare workers to maintain their own mental health), I believe that hardened, impassive, unfeeling physicians do more harm than good with their attitude towards such a sensitive situation.

 

[baxt1412]

You build up a tolerance like everything, but i don't think anyone ever fully gets over witnessing/experiencing a death.

 

[mimelim]

I lost 3 patients last night. One died on the table, two died in the ICU. All 3 died because of extremely morbid pathology. Type A dissection, massive PE, acute mesenteric ischemia. To be honest it didn't really affect me. Maybe a little worse mood overall, but that could have easily been the lack of sleep and being slightly sick. I feel for the families, I spent maybe an hour and a half talking with them during the night, but being busy and being in the OR distracts pretty darn well. At the same time, I think that for me personally, the fact that I know that none of us could have really done much to help them helps ease things.

Yes, younger patients, sudden deaths make things harder, but yes, you get desensitized. I think it would be very hard to survive training if you didn't.

 

[frosted_flake]

For me personally, I feel for the families that are left behind. That is always the hardest part for me.
The ones that get me are the ones that are taking to you one minute, and you are doing chest compressions the next.
To answer your original question though, if you don't talk about it or try to get it out of your mind, it will eat you alive. There needs to be some kind of decompression/venting or I think everyone would go nuts.

 

[RTC19]

...I think that it should always be hard to some extent. So while yes, desensitization is common (and somewhat necessary for the healthcare workers to maintain their own mental health), I believe that hardened, impassive, unfeeling physicians do more harm than good with their attitude towards such a sensitive situation.[/QUOTE]

+1

 

[Bacchus]

I've found it to be very dependent on the situation and my relationship with the patient and their loved ones. Each death will affect you to a different degree. You get more desensitized to it, but it's my opinion you can't ever be full desensititized. I've found terminal diagnoses to be more difficult for me: knowing what the patient may have to go through, knowing a physician-patient relationship will be ending, knowing there is nothing I can do. Whereas with a death, although tragic, is often a reprieve from what the patient was going through.

 

[Theafoni]

I lost 3 patients last night. One died on the table, two died in the ICU. All 3 died because of extremely morbid pathology. Type A dissection, massive PE, acute mesenteric ischemia. To be honest it didn't really affect me. Maybe a little worse mood overall, but that could have easily been the lack of sleep and being slightly sick. I feel for the families, I spent maybe an hour and a half talking with them during the night, but being busy and being in the OR distracts pretty darn well. At the same time, I think that for me personally, the fact that I know that none of us could have really done much to help them helps ease things.

Yes, younger patients, sudden deaths make things harder, but yes, you get desensitized. I think it would be very hard to survive training if you didn't.

So after your shift ends, do you just go back to living your normal life? Like it never happened?

 

[dr.sartorius]

As a physician, especially an ER or trauma doctor, do you become desensitized to death? For example, would it be normal for a doctor to have a patient die on them, but then go on and laugh about one of the nurses farting a few seconds later? Does death just become a routine thing?

I'm not far into my medical career but so far cadaver lab alone has helped desensitize a big part of me, I still have a ways to go but its a process and the more you go through it the more you adjust. I was scared the first day I walked in and saw 50 dead bodies lying on tables, but a few weeks into it nothing phased me.

 

[JakeOgle]

I too am curious about this as I desire to go into medical oncology

 

[Gauss44]

As a physician, especially an ER or trauma doctor, do you become desensitized to death? For example, would it be normal for a doctor to have a patient die on them, but then go on and laugh about one of the nurses farting a few seconds later? Does death just become a routine thing?

Behavior versus Feelings

Based on the description in bold, I would like to draw the distinction between one's behavior and one's feelings. While I understand the context of what you're saying, I think you used a bad example*. The behavior in bold strikes me as having nothing to do with one's feelings of sadness or lack thereof.

More to the point, regardless of other people's experiences, it's important to learn the warning signs of being under too much stress or sadness for your own sake. And it is also important to be aware of your behavior and treatment of others EVEN WHEN times are tough for you. If you need help, get it!

If you need help adjusting, don't hesitate to see a counselor. You don't have to be crazy to get help adjusting to a new place like the ED. And if you get to be under way way too much stress, it is possible to feel emotionally numb, zoned out, and start forgetting things you normally would remember. If that happens or if your friends say you've not been yourself lately, it very well might be time to see an expert who can help you adjust. I don't think anyone would judge you negatively for that. In fact, I think most people would consider that a responsible decision.

*People laugh when they are sad all the time. Haven't you ever had a friend or family member die and started telling stories about that person (who died)? If so, something funny probably came up a few times. And you probably laughed. You were still sad in all likelihood. Additionally, some people are very good at masking and hiding sad emotions and depression (ex. the tough guy thing). Laughing can also be sign of discomfort or unease. etc.

 

[baxt1412]

So after your shift ends, do you just go back to living your normal life? Like it never happened?

if you mourn about it too long, you're never not mourning because you're potentially going to have patients die pretty regularly depending on what position you're in. obviously the relationship/other circumstances surrounding the death will typically dictate how long you will mourn, but it's not emotionally healthy to remain fixated on it for too long.

 

[frosted_flake]

if you mourn about it too long, you're never not mourning because you're potentially going to have patients die pretty regularly depending on what position you're in. obviously the relationship/other circumstances surrounding the death will typically dictate how long you will mourn, but it's not emotionally healthy to remain fixated on it for too long.

👍

 

[Annabell Lee]

Maybe not desensitized, but a lot of health care workers have pretty morbid senses of humor. It's a coping mechanism. Personally, I think there are worse things then death. For me it's easier to accept death than a chronic condition that effects quality of life. As others have stated, age and mechanism of death effect things, so your feelings are going to be on a case by case basis.

When I was working LTC as an aid it was pretty hard on me, because you see these people every day and get to know them and their families on a deeper level. It's a lot harder when it's someone you aren't expecting, which may sound weird but in assisted living lots of these people are relatively healthy and just need some help with ADLs, or don't want to be alone. It's easier when it's expected.

Any loss of life is significant, but honestly watching a trauma patient you've never even spoke to die is completely different from coming to work and finding out someone you've spoken to every day for the past year died a few hours before you came in.