Volunteering and Sadness

[deleted862527]

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Even though it can be very rewarding to volunteer, on the most challenging and toughest of days it can be very depressing. In the Oncology ward, it's not uncommon at all where toddlers die of pediatric cancer despite medical treatment. Their families left with crying, oh my 🙁. It's just so sad.

Sometimes I wonder how docs do it. For any docs reading this how do you? I used to believe in a higher power, but sometimes seeing these tragedies makes me doubtful. Don't get me wrong, it can be VERY rewarding and satisfying to be involved in this and I don't regret it; however, I mean, it just makes me feel sad to see these families grieve when their child dies in a car crash, or of natural causes, or something else.

Sorry for making this thread depressing. I don't want to put a 100% negative view on the whole medical field when it isn't. I just think in many times being in the healthcare industry can bring about the harsh realities of life. From seeing this pediatric kid who is very ill and his family members NOT even having the decency to visit him, to seeing other traumatizing events, geez, it can be pretty difficult to cope with! It also makes you question people's morals

Any thoughts???

 

[getdown]

It's called coping mechanism and compartmentalization. You do what you need to do to destress and help you deal with whatever difficult situation it is you're dealing with. If you like working out, hanging out with friends, a good cry. Do it. It's very important for you to remain even keeled. The other thing is compartmentalizing. Yes, it's very sad when a patient dies ... even more so when it's a child. However, as a physician you can't let that effect you. If you let your emotions get the best of you then you're doing a disservice to the other patients that you have under your care. You can be sad in the moment with the family, take a second to gather yourself, bottle it up for later and move on to the next patient. Unfortunately, the ones I've seen burn out of this field are the ones that either care too much or are unable to find an outlet for their stress.

Another thing to keep in mind is that with the lows of medicine comes the highs as well. With every patient that passes, there's a patient that you're able to save. The wins, though few and far between, make the loses bearable and reinforces why you went into this field in the first place.

 

[FreeRadicals]

I'm not a doctor, but I've heard as a doctor you become desensitized to death in general.

 

[MyOdyssey]

I'm not a doctor, but I've heard as a doctor you become desensitized to death in general.

Perhaps some doctors?

What about family medicine and internal medicine doctors who (hopefully) don't see too many patients dying in their clinics?

 

[FreeRadicals]

Perhaps some doctors?

What about family medicine and internal medicine doctors who (hopefully) don't see too many patients dying in their clinics?

I've sure they have during rotations/residency.

 

[getdown]

Perhaps some doctors?

What about family medicine and internal medicine doctors who (hopefully) don't see too many patients dying in their clinics?

IM does rotations in the MICU where people die all the time.
FM does rotation in the ER where traumas and death are also common.
You can't go through at least training without encountering death.

 

[ciestar]

Perhaps some doctors?

What about family medicine and internal medicine doctors who (hopefully) don't see too many patients dying in their clinics?

Except (with atleast the FM programs ive looked at), you spend a lot more time in the hospital than the clinic. ER, inpatient floors, etc.

 

[Oso]

I'm a new pediatric intern currently on the inpatient heme/onc service. Again, I'm pretty new, but I can offer up some thoughts:

I've definitely had some tough days. Late this afternoon, for example, I ended up admitting a 12 year old girl for fever right as I was about to leave for home. She had previously been a healthy, normal girl, until she was diagnosed with metastatic cancer this past December. Despite multiple rounds of chemo, radiation, and surgery, her disease has progressed. Her prognosis is very poor, and at this point her care is mostly palliative.

In the oncology unit, you are seeing some of the most difficult patients to see: the new diagnoses who are admitted to start treatment for the first time, the patients who have relapsed despite intensive treatment, the patients with severe infections due to being immunosuppressed, the patients with other severe complications from treatment (ex. graft failure after a bone marrow transplant or severe organ damage from really toxic chemo).

You have to remember though, that this is not the whole patient population. In pediatrics, at least, a lot, even most patients (in some types) tend to have good outcomes, you just don't see them in the hospital (unless they come back to visit which is cute as hell). It's hard when you're not seeing a lot of the success stories. And even when you do see them, it's not as rewarding when you're not directly involved or responsible for someone's care (ie. you are a volunteer or a student). I can tell you that these past few weeks, sometimes just knowing that I actually did something real for a patient or their family ... well it actually makes me want to wake up super early in the morning and go to work (which was NOT the case in medical school, at all).

There's great variability in medicine, and you can more or less choose what type of patient population you want to see. When I go to my primary care continuity clinic and most kids are perfectly healthy, I'm initially like "where are these kids coming from?", but then I remember that most kids are actually perfectly healthy. So general pediatrics is a great field for someone who wants to see mostly healthy patients. Want to see a mix of really sick patients and patients who will recover completely? Consider infectious disease. How about patients with chronic, lifelong, but generally manageable disease? Look into endocrinology. These are all just examples. I think most people should be able to find a field where you can work with patients in a way that is meaningful to you but is not going to destroy you and burn you out in the long run.

All this being said, you will have to take care of all types of patients, including the sickest ones, throughout your training, regardless of what your ultimate goal is. So how do you deal with this? Well, whether you like it or not, you will become desensitized to a lot of it. And it happens quickly. There was a huge difference in my ability to deal with these things at the beginning and end of my third year of medical school. It doesn't mean I don't care about the patients anymore, or don't think about them outside of work, because I do. It just means I can leave the hospital and go take my dog for a walk or go out for dinner and drinks with friends still be able to find joy despite knowing that I live in a world where sometimes horrible things happen to people for no good reason at all. It also helps to have a good support system and to make time to do things you enjoy and help relieve stress.

Medicine will be too sad and overwhelming for some people, it's true. It's why it's good to try to get some broad experience volunteering and shadowing beforehand. If you think it's too sad, then maybe it's not for you. But I have very recently found it to be more rewarding than I had previously thought possible -- so if there's something that keeps drawing you in, then I urge you continue to explore the field a little further.

Anyways ... perhaps someone with more experience can provide further insight. Whatever you end up deciding, best of luck to you.

 

[mindlight1]

OP, the sadness can be overwhelming, and it can be difficult to know how to cope when everyone else seems to be doing so well. But there are people who will help you through, and through the emotional turmoil, you begin to feel this sense of connectedness that makes it all worth it. You also learn about your limits, and your strengths and weaknesses, and eventually you find where you are best suited to work...there is a place for everybody.

I also struggled during pediatrics, and I was already in my third year of medical school. I reached out to the attending doctor, who told me that whenever I was feeling like it was too much, I could take a break and come talk to him or go down to the cafeteria, that I didn't have to do this rotation in one certain way. Just knowing I had some breathing room helped me to continue on. I think I spent half the rotation wandering around the hospital, and I thought for sure I was not going to pass, but this doctor ended up doing the opposite and wrote me a kind evaluation. Later on, I learned he had a child of his own who had died, and this solidified for me that life isn't fair, and I had the choice to try to bear up to it all and pay it forward, or avoid. I decided to keep going.

Fast forward to my internship year...I am now a new doctor, and I think I'm ready, and I'm on the heme-onc floor. There's a patient who is my age, who needs a stem cell transplant or else he is going to die, and he just found out that none of his 6 siblings are a match. I go into the room, wondering what it is that I am going to do...I want to be anywhere else but there...and he tells me his story. And then he says, "Thank you for listening." I did nothing, and it feels like he's helping me through. Keep staying the course, I tell myself.

Sometime later, I am talking to a patient who is dying, and it turns out he likes to read mysteries, like I do, and we have the same favorite author. I am truly ready this time, and the next day I bring in for him a book to read, and then he offers me a cookie. I'm actually able to eat it, I notice. I am a part of connectedness when it counts the most. Mentors, friends, family and even patients have gotten me to this point, and it is an honor to be a part of it all.

I hope you can keep going, OP. You sound like you have a heart for people, and that is what's needed. And if I can do it, anyone can. Best wishes to you in your journey, wherever it leads!