Does constantly being around death and illness get you down?

[Brahnold]

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Most of us going into medical school are relatively young, and youth tends to shield us against the unhappy side of life, namely death and dying. Personally, I'm a bit neurotic about growing old and don't like to dwell on the inevitability of old age and its associated maladies too much. I have a feeling that being around very sick, suffering people is not going to brighten up my day all that much, but since I've not had exposure to inpatient medicine, this is all just a guess on my part.

How about you guys who are already in the clinical years? Have you noticed any negative changes in your enthusiasm for life or general mental state as a result of being constantly reminded through your patients of just how much life can suck if you happen to lose your health and/or grow old?

 

[sliceofbread136]

It is often a sobering reminder of our own mortality, but use it as an opportunity to appreciate the time you have and use it well!

 

[takeurmeds02]

It's really sad in kids and younger people. It's still sad in older individuals too but easier to digest when they've lived a relatively full life.

 

[Bacchus]

It's much easier when you know your patients are at peace. I've had several patients die and it was definitely for the better. The younger ones? Not so much. Despite how callous and detached you are, I don't think you can get away from it affecting you. It's much easier the more it happens, but it definitely still affects you.

 

[Moko]

I've only been involved in the care of several patients with terminal illnesses. In my very limited experience, there is often times a lot of opportunity to make a huge impact on the patient and their loved ones when they are at their sickest, both in terms of addressing their concerns, and guiding them through the end-of-life decisions. While it is never easy to deliver bad news, knowing that you kept them comfortable and were there to support them through their darkest times can be quite rewarding. If anything, these experiences have only motivated me to learn more and to appreciate what I currently have.

 

[Cinclus]

Patient death is often quite sad. But Sometimes, it is relieving for all involved. I had a patient with terminal cancer, wasted away to nothing, at death's door and in constant pain, who would beg anyone who came into his room to overdose him on narcotics. He died quickly, and I was relieved for him when I came into the hospital one morning and discovered he passed away overnight.

 

[Mattchiavelli]

It does help me keep good perspective regarding my relatively good health and life. There are lot of people that take for granted getting out of bed, using the bathroom, feeding themselves, etc. and I can appreciate my ability to do said things when I find myself stressing about "first world problem" type stuff. There is some good along with it

 

[LostinLift]

Despite what it may seem like on the internet, many in medicine believe in God. Belief in God is a choice and it was much harder initially than the majority of my life as an atheist. It has been a long process, but I am now walking on a better path. There are many reasons to be sad in this world, but if you believe, there is no reason to despair. Why would you want to go through this world not believing in anything? If you could choose to believe (spoiler alert, you can) that there is a reason to our suffering, that there is life after death... why would you not choose hope? I remember how terrible I felt about the world and humanity, that actually hasn't changed, but now I have hope and faith in more so it does not bother me in the same way.

How do I stay happy around death and suffering? I could go on and on and I'm willing to PM if you want to talk, but basically I choose not to judge anyone for their life choices (the 20 pack year smoking history, obese, DM II, HTN 25 year old for his 4th re-admission this month), I pray for patients and their families (for them to find God, for healing, for peace, for family reconciliation, for any and all things), and finally I begin, end, and traverse my day with God's help. If you see me in the hospital 9/10 I'm smiling, at least on the inside. But don't let me try and convince you, go do research, read books analyzing The Bible, go listen to some sermons, dive into The Bible yourself (stick to New Testament to start until you understand what/why the Old Testament is about). I don't understand why so many people claim to be scientific, yet dismiss God and The Bible before even doing any research themselves.

"The first gulp from the glass of natural sciences will turn you into an atheist, but at the bottom of the glass God is waiting for you."

 

[URHere]

There's a range in how people respond to working with the critically ill. Personally, I find pediatric disease to more emotionally manageable than adult disease, mostly because children are astoundingly adaptable. A 5 year old with a stroke grows up with their deficits and can build a meaningful life with what they have. For me, that is so much less devastating than watching a 50 year old lose his/her identity, job, and/or relationships after a similar problem.

All things considered, I'm glad I took this path. It's still hard for me to believe that a profession exists where complete strangers will trust you with their lives and tell you their most intimate personal details...but that's the core of medicine. People put an incomprehensible amount of faith in their physicians and that is downright humbling. It can be sad at times, but as far as I'm concerned, that's a fair trade-off.

 

[Cinclus]

Despite what it may seem like on the internet, many in medicine believe in God. Belief in God is a choice and it was much harder initially than the majority of my life as an atheist. It has been a long process, but I am now walking on a better path. There are many reasons to be sad in this world, but if you believe, there is no reason to despair. Why would you want to go through this world not believing in anything? If you could choose to believe (spoiler alert, you can) that there is a reason to our suffering, that there is life after death... why would you not choose hope? I remember how terrible I felt about the world and humanity, that actually hasn't changed, but now I have hope and faith in more so it does not bother me in the same way.

Off-topic, but I disagree. You cannot force belief. You either believe in something, or you do not. You cannot simply will it to happen. Just for example, and not meant to offend: As fun and magical it was for me to believe in Santa Claus as a kid, those days are over...no more believing, no matter how much I may desire to believe; I cannot make that choice to believe. Glad to hear you are happy/at peace, though.

 

[SasquatchEM]

Makes you appreciate what you have a little bit more.

 

[LostinLift]

Off-topic, but I disagree. You cannot force belief. You either believe in something, or you do not. You cannot simply will it to happen. Just for example, and not meant to offend: As fun and magical it was for me to believe in Santa Claus as a kid, those days are over...no more believing, no matter how much I may desire to believe; I cannot make that choice to believe. Glad to hear you are happy/at peace, though.

A fun and for some never-ending philosophical debate about voluntarism/involuntarism, but I will address your analogy. I understand you did not intend offense and I do not take any from what has classically been an offense-intended argument, but that is a false equivalence fallacy. You are assuming both God and Santa are imaginary and without evidence. Whereas Santa Claus comes from folklore and no sane adult believes to be true, this is not true with God or gods. For these, we do have writings that claim to be actual accounts of a being or beings the writers claim have made themselves known to men, or whose existences men have logically deduced from what they have observed about the world around them.

That is, for these, someone claims to have seen evidence. This fact alone puts the idea of God or gods in an entirely separate category from fairies, bogeymen, monsters, super heroes, and even non-fantastical characters from known fiction. The latter are fantasies people deliberately indulge for the sake of fun, or to pass along to children to last only for a time. Those who pass them on don't believe them themselves.

Tales of God—especially written—are different. They mean to convince people of truth. They are trying to permanently affect someone's thinking, and are thus more serious in nature. That doesn't mean they are not false. But it does present you with a choice to accept or reject the evidence that exists in our world.

(This argument was summarized from another's long post on the subject. Edit reject, not refute the evidence)

 

[J ROD]

I mean you get used to it. At the beginning of 3rd yr, I was it was sort of shocking to see someone die in front of you. Now, at the end of 4th yr, I barely even give it a thought.

Sad, but true.

 

[DetectiveAlonzo]

My man J Dub always keeps it real.

 

[Bacchus]

My moment was when I had two patients die within 10 minutes of each other in the ICU. I wasn't even done talking with one family when I saw the telemetry go asystole on the 2nd patient. It was a rough night.

 

[sloop]

While occasionally tragic, it is often the case that when people die, it is really for the best. Despite things not always working out this way, the goal of medicine is not supposed to be just prolonging life to no conceivable end. It is supposed to be about letting them live fulfilling lives.

Sometimes this means trying to keep people alive. Sometimes it doesn't.

 

[tiedyeddog]

Sadly, you get used to it. I am around it so much I have become jaded to it. I have harmed people permanently with the procedures I have done trying to help them, the feeling that causes is gut wrenching.

"Whoever fights monsters should see to it that in the process he does not become a monster. And if you gaze long enough into an abyss, the abyss will gaze back into you." Friedrich Nietzsche

 

[CherryRedDracul]

 

[J ROD]

Just had to review autopsy pics on a 5 yo that was beat to death today.

Now, that bothered me and I hope it would most of you.

 

[WingedOx]

I mean you get used to it. At the beginning of 3rd yr, I was it was sort of shocking to see someone die in front of you. Now, at the end of 4th yr, I barely even give it a thought.

Sad, but true.

In a lot of ways dealing with death is easier than some of the other things I've dealt with. Things like the psychological effects childhood sexual abuse, sexual assault, etc are far more difficult. I'm also psych, so I'm seeing the fallout of that stuff more than other specialties.

 

[mimelim]

In our specialty patients don't typically live very long. My program director told me during intern orientation, "Half of the patients you see this year will die before you leave this residency." I am currently running a clinical trial that the average life expectancy is 14 months (non-cancer patients mind you). I was on call this past weekend and we lost 2 patients, at M&M this week, we had to review 5 deaths. Higher than normal, yes, but certainly not crazy. It is a weekly part of my job. As others have said, you 'get used to it'. Where 'it' is the concept of death. But, as @J DUB points out, there are always going to be cases that still upset you. Most of them are the unexpected. For example, the patient coming in for elective surgery that dies on the table or ends up in the ICU always illicit a strong response, mostly because the patients are talking to you pre-op and they seem so 'normal'. And then there are those that are just so outside of the norm that it still hits you. For me it was pediatric trauma while I was on trauma surgery. Kids die. Kids get very badly hurt. When you see it, it is heart breaking.

 

[J ROD]

Just had to review autopsy pics on a 5 yo that was beat to death today.

Now, that bothered me and I hope it would most of you.

In a lot of ways dealing with death is easier than some of the other things I've dealt with. Things like the psychological effects childhood sexual abuse, sexual assault, etc are far more difficult. I'm also psych, so I'm seeing the fallout of that stuff more than other specialties.

Yeah, I am on a child abuse elective now and it is hard.

 

[Trefoil]

A fun and for some never-ending philosophical debate about voluntarism/involuntarism, but I will address your analogy. I understand you did not intend offense and I do not take any from what has classically been an offense-intended argument, but that is a false equivalence fallacy. You are assuming both God and Santa are imaginary and without evidence. Whereas Santa Claus comes from folklore and no sane adult believes to be true, this is not true with God or gods. For these, we do have writings that claim to be actual accounts of a being or beings the writers claim have made themselves known to men, or whose existences men have logically deduced from what they have observed about the world around them.

That is, for these, someone claims to have seen evidence. This fact alone puts the idea of God or gods in an entirely separate category from fairies, bogeymen, monsters, super heroes, and even non-fantastical characters from known fiction. The latter are fantasies people deliberately indulge for the sake of fun, or to pass along to children to last only for a time. Those who pass them on don't believe them themselves.

Tales of God—especially written—are different. They mean to convince people of truth. They are trying to permanently affect someone's thinking, and are thus more serious in nature. That doesn't mean they are not false. But it does present you with a choice to accept or reject the evidence that exists in our world.

(This argument was summarized from another's long post on the subject. Edit reject, not refute the evidence)

On this topic, I really don't see belief as a choice either. I grew up in a very religious family and sort of went with it for a period, but eventually, I could not follow their beliefs anymore, as in I was literally not capable.

This sort of sent me into a weird existential crisis where I thought everything was meaningless, but I came out in the other side being comforted by the sheer insignificance of humanity. This may sound odd, but when you think of us as dust in a space so vast that we cannot even fathom our own insignificance, that is magnificent in a sense.

I love that we came from a singularity so small that it cannot be seen with the naked eye and that we may one day return to this singular form even if our matter is obliterated in the process. Or instead, we may expand endlessly stretching infinitely into the void, perhaps one day colliding with other expanding universes that have since fallen, and perhaps forming a new universe of mixed matter. It is almost pseudo religious.

I do sympathize with the religious, but I cannot be religious. It's not in my code. So I do my best to meet in the middle. I never discuss my beliefs with religious patients because we are all on our own journeys and need to understand the world in our own way.

For me this means that the dying patient in front of me, and I came from the same singularity. We are forever united in this way. We are of the same star dust and that is just absolutely beautiful to me. Death and illness becomes insignificant in the grandness of it all. Anyway, sorry for my crazy babble. Hope I didn't offend anyone.

 

[Donald Juan]

Despite what it may seem like on the internet, many in medicine believe in God. Belief in God is a choice and it was much harder initially than the majority of my life as an atheist. It has been a long process, but I am now walking on a better path. There are many reasons to be sad in this world, but if you believe, there is no reason to despair. Why would you want to go through this world not believing in anything? If you could choose to believe (spoiler alert, you can) that there is a reason to our suffering, that there is life after death... why would you not choose hope? I remember how terrible I felt about the world and humanity, that actually hasn't changed, but now I have hope and faith in more so it does not bother me in the same way.

How do I stay happy around death and suffering? I could go on and on and I'm willing to PM if you want to talk, but basically I choose not to judge anyone for their life choices (the 20 pack year smoking history, obese, DM II, HTN 25 year old for his 4th re-admission this month), I pray for patients and their families (for them to find God, for healing, for peace, for family reconciliation, for any and all things), and finally I begin, end, and traverse my day with God's help. If you see me in the hospital 9/10 I'm smiling, at least on the inside. But don't let me try and convince you, go do research, read books analyzing The Bible, go listen to some sermons, dive into The Bible yourself (stick to New Testament to start until you understand what/why the Old Testament is about). I don't understand why so many people claim to be scientific, yet dismiss God and The Bible before even doing any research themselves.

"The first gulp from the glass of natural sciences will turn you into an atheist, but at the bottom of the glass God is waiting for you."

Yann Martel fan?

 

[ZPakEffect]

Despite what it may seem like on the internet, many in medicine believe in God. Belief in God is a choice and it was much harder initially than the majority of my life as an atheist. It has been a long process, but I am now walking on a better path. There are many reasons to be sad in this world, but if you believe, there is no reason to despair. Why would you want to go through this world not believing in anything? If you could choose to believe (spoiler alert, you can) that there is a reason to our suffering, that there is life after death... why would you not choose hope? I remember how terrible I felt about the world and humanity, that actually hasn't changed, but now I have hope and faith in more so it does not bother me in the same way.

How do I stay happy around death and suffering? I could go on and on and I'm willing to PM if you want to talk, but basically I choose not to judge anyone for their life choices (the 20 pack year smoking history, obese, DM II, HTN 25 year old for his 4th re-admission this month), I pray for patients and their families (for them to find God, for healing, for peace, for family reconciliation, for any and all things), and finally I begin, end, and traverse my day with God's help. If you see me in the hospital 9/10 I'm smiling, at least on the inside. But don't let me try and convince you, go do research, read books analyzing The Bible, go listen to some sermons, dive into The Bible yourself (stick to New Testament to start until you understand what/why the Old Testament is about). I don't understand why so many people claim to be scientific, yet dismiss God and The Bible before even doing any research themselves.

"The first gulp from the glass of natural sciences will turn you into an atheist, but at the bottom of the glass God is waiting for you."

What scientific evidence is there that supernatural entities exist? Seriously, it's fine that you believe in a deity but don't try to pretend that there's any serious scientific evidence for it.

 

[hallowmann]

Just had to review autopsy pics on a 5 yo that was beat to death today.

Now, that bothered me and I hope it would most of you.

I know a Forensic Pathologist in a medical examiner's office in a big city that has worked there for 30 years and still gets affected by those cases. And as you said, I hope he and anyone else would. I've only seen a couple autopsies like that, and I remember every part of them.

 

[Cytarabine]

In a lot of ways dealing with death is easier than some of the other things I've dealt with. Things like the psychological effects childhood sexual abuse, sexual assault, etc are far more difficult. I'm also psych, so I'm seeing the fallout of that stuff more than other specialties.

Everyone has their own 'thing', that happens to be mine. I thought I was going to do child and adolescent psych, but the prevalence of physical and sexual abuse and neglect and the depth to which you have to become involved in their "stories" was too much. And seeing the abused finally come into mental health system after having become abusers themselves, ugh. There are fates worse than death

I guess broadly speaking, the patients I find the most emotionally taxing are the ones I perceive to be condemned to living a life not worth living. The hyperobese functional paraplegic who's been trached and has the sacral decub you could stick your head in, the kids with ridiculous HIE or post-meningitis encephalomalacia who are essentially just a brain stem and a body, etc

 

[Doctor Strange]

Psych has definitely been the hardest rotation for me emotionally so far. On the other rotations I've been on, I could go home and put the day behind me. On psych, I sometimes finding myself figuratively bringing patients home with me and thinking about their conditions. Working in the unit with acutely psychotic patients was one thing but working with borderline personalities who have had just god-awful lives is a complete other ballgame.

 

[Merely]

Despite what it may seem like on the internet, many in medicine believe in God. Belief in God is a choice and it was much harder initially than the majority of my life as an atheist. It has been a long process, but I am now walking on a better path. There are many reasons to be sad in this world, but if you believe, there is no reason to despair. Why would you want to go through this world not believing in anything? If you could choose to believe (spoiler alert, you can) that there is a reason to our suffering, that there is life after death... why would you not choose hope? I remember how terrible I felt about the world and humanity, that actually hasn't changed, but now I have hope and faith in more so it does not bother me in the same way.

How do I stay happy around death and suffering? I could go on and on and I'm willing to PM if you want to talk, but basically I choose not to judge anyone for their life choices (the 20 pack year smoking history, obese, DM II, HTN 25 year old for his 4th re-admission this month), I pray for patients and their families (for them to find God, for healing, for peace, for family reconciliation, for any and all things), and finally I begin, end, and traverse my day with God's help. If you see me in the hospital 9/10 I'm smiling, at least on the inside. But don't let me try and convince you, go do research, read books analyzing The Bible, go listen to some sermons, dive into The Bible yourself (stick to New Testament to start until you understand what/why the Old Testament is about). I don't understand why so many people claim to be scientific, yet dismiss God and The Bible before even doing any research themselves.

"The first gulp from the glass of natural sciences will turn you into an atheist, but at the bottom of the glass God is waiting for you."

Numerous studies have found that most scientists and philosophers are non-religious/atheist/certainly NOT christian. I'm sure you know something that the smartest intellectuals of our time who have devoted their life to this question don't...

 

[frosted_flake]

Like @sliceofbread136 said. It reminds you of your own morality and how precious life is.

After a particularly bad day at work I come home and hug my family extra tight or make a much neglected phone call.



On that thought, one thing that really bothers me is running a code on an elderly individual. I remember one patient who was so small and frail (mid eighties) and he had been worked so long that frothy sputum and blood were coming out of his nose, up the ET tube, etc. Any chest structure he had was non-existent anymore we had worked the man so long. It is something I wish I could forget. I was relieved when they called the code. I didn't see any good coming out of a resuscitation in that situation.
🙁


I need to go pet some kittens at the pet store now that I am all bummed out. I think it is good to talk about this stuff though, it really helps.

 

[Cinclus]

On this topic, I really don't see belief as a choice either. I grew up in a very religious family and sort of went with it for a period, but eventually, I could not follow their beliefs anymore, as in I was literally not capable.

This sort of sent me into a weird existential crisis where I thought everything was meaningless, but I came out in the other side being comforted by the sheer insignificance of humanity. This may sound odd, but when you think of us as dust in a space so vast that we cannot even fathom our own insignificance, that is magnificent in a sense.

I love that we came from a singularity so small that it cannot be seen with the naked eye and that we may one day return to this singular form even if our matter is obliterated in the process. Or instead, we may expand endlessly stretching infinitely into the void, perhaps one day colliding with other expanding universes that have since fallen, and perhaps forming a new universe of mixed matter. It is almost pseudo religious.

I do sympathize with the religious, but I cannot be religious. It's not in my code. So I do my best to meet in the middle. I never discuss my beliefs with religious patients because we are all on our own journeys and need to understand the world in our own way.

For me this means that the dying patient in front of me, and I came from the same singularity. We are forever united in this way. We are of the same star dust and that is just absolutely beautiful to me. Death and illness becomes insignificant in the grandness of it all. Anyway, sorry for my crazy babble. Hope I didn't offend anyone.

I have also experienced comfort in this.

 

[deleted407021]

I have also experienced comfort in this.

Likewise, and the fact that we are the Universe thinking about itself is quite transcendent.