Overcoming feelings of death?

[S_R]

Hi!

I am not sure, if this is the right place to post this new thread but anyway, I'll just ask my question.

Just wanted to know, when did you experience your first "patient dying" experience, how did you feel about it? And how long did it take you to get over those feelings?

Thanks

Regards-

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[USAF MD '05]

The first patient that really made me upset when she died was a 28 year old AIDS patient. I admitted her to the ICU one night due to uncontrollable, explosive diarrhea. I spent a couple of hours with her in the ED getting her story and just doing a little hand-holding. She was very sweet, married with 2 beautiful kids, and dying. She was not a druggie, not a *****- she got involved with the wrong man one time when she was 19. I think I got so attached because we were the same age, bot had kids, and had both made some stupid mistakes in our youth. She was dying for hers, and I came away scott free. Gives you a guilty feeling inside.
She died the next morning about one hour before I got to work. I teared up a little, and was down for a couple of hours. I have always been a very emotional person for a short time after a death, and then for some reason can easily put it behind me. That is not to say she didn't leave a mark on me-she did- but that it didn't really affect me much beyond the initial couple of hours.
Now, death comes more often, and I am less affected by it. I am relieved for many, because it is an end to suffering.
We all deal with things in our own way, we just can't it affect our job performance.
Good luck.

 

[cjw0918]

I remember one patient with newly diagnosed metastatic lung CA. When he was leaving the hospital, he told me that I was the bright spot in his days there. Being a clueless new third year, this meant the world to me. I really was doing SOMETHING, even if I didn't know anything about clinical medicine yet. One week later he shot himself. I saw his obituary in the paper. He had told me he wanted to die at home and not suffer. I never thought that that meant suicide. I just thought he didn't want to be in the hospital.

Although I did not watch this patient die, I was very sad for him.

Most people that die I feel bad for their families if it was unexpected. Sometimes it is a relief.

What I often find more disturbing than death is suffering. Maybe I am biased because I am going into path, but there is a certain peace about the dead. They're not in pain and spiritually I believe they are somewhere better.

Good luck. It's hard for all of us.

 

[fergusondoc]

Over the years I have been with both of my grandfathers as they had died. Watching them slowly take each breath afraid the next would be their last. It was not until my mother died last November did I fully appreciate the importance of not shying away from death. I realized that my fear of my own mortality kept me from being close to those to the dying.

As a doctor I have been on the other end of the dying process being involved with the delivery of infants who have died in-utero or soon after.

My recommendation is to fight the urge to shy away from the dying. Instead embrace them(it's not easy) and you will begin to understand a deeper since of what being a doctor can be.

 

[Febrifuge]

Agree with the above -- preparing a body and transporting it to the ME's office is not that hard for me. Being witness to suffering is hard. And while it can be tough caring for someone who is in distress but medicated and won't remember much, or someone who's in pain but has a team fighting to make them better, it's worse talking to the family of a patient who's in the OR or the ICU, and seeing the fear and the helplessness on their faces.

 

[Molecule]

I've had two experiences with death in medical school.

The first time was on Neurology, when a young man who was shooting himself up with meth was brought in for loss-of-consciousness. He was extremely hypertensive on presentation, and the CT showed a massive pontine bleed. "This man's toast," one attending said.

The next morning, I was responsible for irrigating an ear with ice water to see if his eyes would "move to the ice." They didn't. My hands shook as I pushed the syringe...because I had never been in a situation with this much gravity before. My whole team was assembled around.

The patient's eyes never budged. His pupils were blown and fixed.

And the attending that morning simply said, "Alright. This man's not coming back."

Out in the hallway, the patient's wife was crying...and all the neighbors that lived near the couple were assembled in the hallway. A staggering number of people.

My attending didn't have the most sensitive comments to pass to the wife as we left the room. But I remembered the emotion that welled-up inside me as I saw all those people that were affected by this patient's death.

Despite the meth story, I guess I didn't feel as judgmental toward the patient as my attending. I looked at all those people and thought about how much this man was loved in life. For a moment, I wanted to cry...but I went on with my day's work. And filed this moment away in my memory...one of my first patient stories of third year.

 

[impetigo]

She was not a druggie, not a *****- she got involved with the wrong man one time when she was 19.

Yeah, that would make her pretty unsympathetic eh?

 

[USAF MD '05]

Yeah, that would make her pretty unsympathetic eh?

Nope- not unsympathetic at all. I was just describing why I felt such a bond with her. We had much in common, and I was very aware that she could have been me, without much of an imaginative stretch at all. I think everyone feels a little more when they identify with the patient. In the same vein, I am a motorcycle rider, and when comatose MCC patients come into the ED I am always aware that this could be me if I am not careful. Docs who don't ride don't get it, and treat them like idiots.
There but for the grace of God go I....

 

[S_R]

Over the years I have been with both of my grandfathers as they had died. Watching them slowly take each breath afraid the next would be their last. It was not until my mother died last November did I fully appreciate the importance of not shying away from death. I realized that my fear of my own mortality kept me from being close to those to the dying.

As a doctor I have been on the other end of the dying process being involved with the delivery of infants who have died in-utero or soon after.

My recommendation is to fight the urge to shy away from the dying. Instead embrace them(it's not easy) and you will begin to understand a deeper since of what being a doctor can be.

Thank you all very much for responding to my question.

In a span of three years both my grandfathers passed away, I was very very close to them. I witnessed one, and my other grandfather - he passed away all of a sudden and it was such a shock to the whole family.

I think about my grandfathers now, how they passed away, and I still feel all these emotions that I cannot comprehend, it's more than just sadness, I hope you all know what I am talking about.

My fear is, when I start rotations (which is in about three years) & when I encounter a dying patient, I might just break down in front of everyone - the doctors, my fellow classmates & the patients! And that certainly would NOT be a professional thing to do - aren't med students and doctors there to support the others who are hurt - paining inside?

Like you said fergusondoc, I know I have to learn to embrace the dying but does this come out of frequent "meetings"/encounters? Can I embrace it and not grow a cold heart towards death?

I think the reason as to why most of us shy away from death is because it causes us so much pain/hurt inside....it brings back very painful memories..

Do doctors get "used" to death & dying? I hope I didn't word that wrong...