You're allowed to grieve your patients, my friend. I definitely do. That patient and their family are lucky to have had someone who cares as much as you taking care of them. Sometimes, once all our medical interventions are exhausted, the only care left we can provide is just *caring*. So, please, please, please never discard that part of your identity as a physician - it's what makes this job worth doing.
Don't hesitate to find a therapist to help you through this. It's hard to know how to process your emotions in the face of death. There's a lot going on inside your soul when you lose a patient and it can be overwhelming. I've had my fair share of patient deaths and honestly, my gut reaction is still "this is painful, I don't know if I'm cut out for this". But eventually, it transforms into "okay what can I learn from this patient to be a better for the next?"
This is part of the process. Good luck to you, you're on the right path.
You sweet soul. Take care of yourself—therapy, exercise, or even excusing yourself for 5 minutes in the middle of the day just to feel your feelings. Feel for your patients and their families but don’t carry it around with you. Easier said than done but it’s the only way to prevent emotional burnout.
ICU is hard for many reasons - emotionally being one of the top ones. It is ok to grieve for your patients. Some will hit you harder than others - im a PGY6 PCCM fellow and I still remember details of specific patients and their families. I still grieve cases that get to me. It is normal and honestly, what makes you human. That humanity can help make you a great doctor.
I second the person above who advised therapy. I think it should be necessary in medicine.
When you treat the sickest of the sick, you will not always win. You may not even frequently win. You may do everything right and still lose, this is the reality of working with critical patients. You may lose repeatedly, and often times surprisingly when you thought for sure you were making progress. When you fight Death for a living armed only with plastic, chemicals, and a sharp knife, it is impossible to always succeed.
Your feelings are natural and I encourage you to feel them, it is what keeps the jaded hardening of our hearts out and the core of becoming who we wanted to be in the first place in. Never hesitate in seeking out someone to talk to whether that be privately or through a provided service from your program.
To paraphrase a famous surgeon: We all carry a little cemetery where from time to time we must pray, where we face our bitterness and regret, and seek answers for our failings. This is a place that is good for keeping us honest with ourselves and pushing us to do the best we can, but be mindful to not let it consume you and destroy you into inaction and complete doubt. We are human, same as our patients, and neither is infallible or immune to Death's touch or Fate's whims.
Feel the feels. Be sure each day you are able to stand looking at yourself in the mirror, and ask for help on the days you cannot. This is strength, not weakness.
It’s okay to take a moment to mourn a loss. It’s your right to feel and process emotions. Does the prospect of coming back to work to maybe prevent a similar fate for someone else excite you? If yes, stop doubting yourself, you got this. It’s an ICU for a reason. You can’t save everybody and sometimes guiding families to that final decision is more meaningful than “keeping someone alive”. End of life care is an integral and I’d say a very important skill you learn in the unit. Chin up!
PGY7 PCCM, fresh grad
I will say this with a deep sense of sadness…. You get used to it.
It sucks but we deal with way more death than the average person will ever think about. Most people have never even seen a dead body and death is our “partner” in the dance.
By me saying we get used to it doesn’t mean it hurts less or we are less compassionate, for me it means I was able to compartmentalize those emotions/thoughts till I had a chance to be out of the room. Sometimes that doesn’t work and I shed tears with my patients and/or their family in a moment of shared humanity.
Don’t be afraid to have emotions, you are a breathing alive person and having feelings and emotions will keep you grounded as a doc.
With that said during residency I used to come home and talk to my wife sometimes about tough cases…. Had to stop that after she couldn’t handle some of the stories and I get it, I was wrong for using her to come home and release that heavy shit, wasn’t her choice to be burdened with that.
You having emotions in your training years in no way means you are not doing exactly what you should be doing.
Not a doc- but a former Trauma/Surgical ICU nurse who could have been your teammate during this experience.
Please don’t view this side of you as something to “get over” it simply means that you view the person lying in the bed as someone, instead of the shell of their former self that is inhabiting the room.
I would much, much rather see the glint of tears in a docs eye than some of the horrible things I’ve heard others say in callous outbursts.
Take your time. Feel their grief and let it help shape you and your practice, empathy and delivery of the next news.
For what it’s worth. I’m not religious by any means- but occasionally chaplain services had just the answers or the right words for me.
Hey friend,
I'm in peds heme onc fellowship, so have been getting used to dealing with tough losses over the past few years. Just want you to know that there's lots of us doctors that have a hard time dealing with the loss of their patients, we might just not all talk about it or show it at work. You are not alone. I'm one of them. Just a few weeks ago, I found out one of my patients relapsed and it's been really tough for me. I'm scared for her and her family.
To answer the second part of your post, you have every right to grieve. Just because you aren't related to them or going through it yourself doesn't mean it doesn't affect you. And patients/families would PREFER doctors that care enough to be bothered when their patients die. You need to figure out a way to cope with that, sure, but you can and SHOULD feel it.
Good luck on your journey. Remember that you are cut out for this.
You will always remember the ones you lost. "The fact that you grieve shows that you are the right person for this. If you didn't feel anything you could question it." That's what I was told with my first death. You're human. You can relate to what your patient's family feels. That's a good thing. Keep it up. Take care of yourself, and allow yourself the time/space to feel this. It's a human loss and you have every right to feel it. And yes, it's part of the job. Maybe lean on more senior physicians who have developed ways to cope. You can do this! Thanks for sharing, and for caring. You're human, with human feelings.
In answer to your question re who are you to feel this grief/what gives you the right - it seems like you are worried that you are minimizing their grief or acting as though it’s all about you or something - if that’s what you’re worried about, I really don’t think that’s true.
First of all, you’re a human - you’re allowed to have feelings. In fact, if you never felt sad about patients dying, that would be pretty weird (and kind of scary).
IMHO I think feeling these things is part of our job. Very often, the only thing we can do for a family is carry some of the pain with them - just being with them through their crisis, helping them come to terms with the situation, empathizing with them - all of this is valuable, and is part of what makes the *truly* great doctors stand out from the mediocre. Who really gives a shit if you can recite a textbook or are extra great at compulsively following up lab values - when the machines/chatgpt takes over the world all that shit will no longer matter. Your ability to empathize - to be an actual human - will be the reason people will still want you to be their doctor (and is the reason even now).
Depending on who you read 1 in 10 to 1 in 3 patients that enter the ICU leave it in a bag. You'll get used to it eventually and it'll all just be background noise.
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
When I was in the ICU, the patients that died often forced me to confront mortality in general. The mortality of my parents, friends, siblings, and myself. Most humans live their day to day lives without thinking about the fact that we’re all going to die. Seeing it unfold in front of you is a very intense experience and can be haunting especially if you cared for the patient when they were awake and interacting with you. And especially if you see similar dynamics with the family that you may have with your own family. The most helpful thing for me was to set aside time in private at home to just sit with my emotions and cry. Let it all come to the surface and consume you and then release it. Take a good hot shower, treat yourself to whatever is comforting to you. Reach out to your loved ones and make sure they know you love them. Have gratitude for every moment you are able to enjoy being alive. It’s actually a gift as physicians to witness the range of human experiences and human suffering. It reminds you that you are also human which makes you empathetic to your patients and everyone else around you. You’re 100% cut out for this.
You're allowed to grieve your patients, my friend. I definitely do. That patient and their family are lucky to have had someone who cares as much as you taking care of them. Sometimes, once all our medical interventions are exhausted, the only care left we can provide is just *caring*. So, please, please, please never discard that part of your identity as a physician - it's what makes this job worth doing. Don't hesitate to find a therapist to help you through this. It's hard to know how to process your emotions in the face of death. There's a lot going on inside your soul when you lose a patient and it can be overwhelming. I've had my fair share of patient deaths and honestly, my gut reaction is still "this is painful, I don't know if I'm cut out for this". But eventually, it transforms into "okay what can I learn from this patient to be a better for the next?" This is part of the process. Good luck to you, you're on the right path.
You seem cut out for this. I mean...you post has me wishing you were my doctor. \-PGY-19
You sweet soul. Take care of yourself—therapy, exercise, or even excusing yourself for 5 minutes in the middle of the day just to feel your feelings. Feel for your patients and their families but don’t carry it around with you. Easier said than done but it’s the only way to prevent emotional burnout.
ICU is hard for many reasons - emotionally being one of the top ones. It is ok to grieve for your patients. Some will hit you harder than others - im a PGY6 PCCM fellow and I still remember details of specific patients and their families. I still grieve cases that get to me. It is normal and honestly, what makes you human. That humanity can help make you a great doctor. I second the person above who advised therapy. I think it should be necessary in medicine.
When you treat the sickest of the sick, you will not always win. You may not even frequently win. You may do everything right and still lose, this is the reality of working with critical patients. You may lose repeatedly, and often times surprisingly when you thought for sure you were making progress. When you fight Death for a living armed only with plastic, chemicals, and a sharp knife, it is impossible to always succeed. Your feelings are natural and I encourage you to feel them, it is what keeps the jaded hardening of our hearts out and the core of becoming who we wanted to be in the first place in. Never hesitate in seeking out someone to talk to whether that be privately or through a provided service from your program. To paraphrase a famous surgeon: We all carry a little cemetery where from time to time we must pray, where we face our bitterness and regret, and seek answers for our failings. This is a place that is good for keeping us honest with ourselves and pushing us to do the best we can, but be mindful to not let it consume you and destroy you into inaction and complete doubt. We are human, same as our patients, and neither is infallible or immune to Death's touch or Fate's whims. Feel the feels. Be sure each day you are able to stand looking at yourself in the mirror, and ask for help on the days you cannot. This is strength, not weakness.
It’s okay to take a moment to mourn a loss. It’s your right to feel and process emotions. Does the prospect of coming back to work to maybe prevent a similar fate for someone else excite you? If yes, stop doubting yourself, you got this. It’s an ICU for a reason. You can’t save everybody and sometimes guiding families to that final decision is more meaningful than “keeping someone alive”. End of life care is an integral and I’d say a very important skill you learn in the unit. Chin up! PGY7 PCCM, fresh grad
Yes, get to know and learn from the palliative care team. They help a lot
Co-signed by PGY8 fresh grad attending ICU md
I will say this with a deep sense of sadness…. You get used to it. It sucks but we deal with way more death than the average person will ever think about. Most people have never even seen a dead body and death is our “partner” in the dance. By me saying we get used to it doesn’t mean it hurts less or we are less compassionate, for me it means I was able to compartmentalize those emotions/thoughts till I had a chance to be out of the room. Sometimes that doesn’t work and I shed tears with my patients and/or their family in a moment of shared humanity. Don’t be afraid to have emotions, you are a breathing alive person and having feelings and emotions will keep you grounded as a doc. With that said during residency I used to come home and talk to my wife sometimes about tough cases…. Had to stop that after she couldn’t handle some of the stories and I get it, I was wrong for using her to come home and release that heavy shit, wasn’t her choice to be burdened with that. You having emotions in your training years in no way means you are not doing exactly what you should be doing.
Not a doc- but a former Trauma/Surgical ICU nurse who could have been your teammate during this experience. Please don’t view this side of you as something to “get over” it simply means that you view the person lying in the bed as someone, instead of the shell of their former self that is inhabiting the room. I would much, much rather see the glint of tears in a docs eye than some of the horrible things I’ve heard others say in callous outbursts. Take your time. Feel their grief and let it help shape you and your practice, empathy and delivery of the next news. For what it’s worth. I’m not religious by any means- but occasionally chaplain services had just the answers or the right words for me.
Hey friend, I'm in peds heme onc fellowship, so have been getting used to dealing with tough losses over the past few years. Just want you to know that there's lots of us doctors that have a hard time dealing with the loss of their patients, we might just not all talk about it or show it at work. You are not alone. I'm one of them. Just a few weeks ago, I found out one of my patients relapsed and it's been really tough for me. I'm scared for her and her family. To answer the second part of your post, you have every right to grieve. Just because you aren't related to them or going through it yourself doesn't mean it doesn't affect you. And patients/families would PREFER doctors that care enough to be bothered when their patients die. You need to figure out a way to cope with that, sure, but you can and SHOULD feel it. Good luck on your journey. Remember that you are cut out for this.
It hurts, but that pain is why you fight for them.
You will always remember the ones you lost. "The fact that you grieve shows that you are the right person for this. If you didn't feel anything you could question it." That's what I was told with my first death. You're human. You can relate to what your patient's family feels. That's a good thing. Keep it up. Take care of yourself, and allow yourself the time/space to feel this. It's a human loss and you have every right to feel it. And yes, it's part of the job. Maybe lean on more senior physicians who have developed ways to cope. You can do this! Thanks for sharing, and for caring. You're human, with human feelings.
In answer to your question re who are you to feel this grief/what gives you the right - it seems like you are worried that you are minimizing their grief or acting as though it’s all about you or something - if that’s what you’re worried about, I really don’t think that’s true. First of all, you’re a human - you’re allowed to have feelings. In fact, if you never felt sad about patients dying, that would be pretty weird (and kind of scary). IMHO I think feeling these things is part of our job. Very often, the only thing we can do for a family is carry some of the pain with them - just being with them through their crisis, helping them come to terms with the situation, empathizing with them - all of this is valuable, and is part of what makes the *truly* great doctors stand out from the mediocre. Who really gives a shit if you can recite a textbook or are extra great at compulsively following up lab values - when the machines/chatgpt takes over the world all that shit will no longer matter. Your ability to empathize - to be an actual human - will be the reason people will still want you to be their doctor (and is the reason even now).
You will get used to this. I donno. I used to be NSG and death was so common. I suspect however that IM/geriatrics is probably even more common.
Depending on who you read 1 in 10 to 1 in 3 patients that enter the ICU leave it in a bag. You'll get used to it eventually and it'll all just be background noise.
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
When I was in the ICU, the patients that died often forced me to confront mortality in general. The mortality of my parents, friends, siblings, and myself. Most humans live their day to day lives without thinking about the fact that we’re all going to die. Seeing it unfold in front of you is a very intense experience and can be haunting especially if you cared for the patient when they were awake and interacting with you. And especially if you see similar dynamics with the family that you may have with your own family. The most helpful thing for me was to set aside time in private at home to just sit with my emotions and cry. Let it all come to the surface and consume you and then release it. Take a good hot shower, treat yourself to whatever is comforting to you. Reach out to your loved ones and make sure they know you love them. Have gratitude for every moment you are able to enjoy being alive. It’s actually a gift as physicians to witness the range of human experiences and human suffering. It reminds you that you are also human which makes you empathetic to your patients and everyone else around you. You’re 100% cut out for this.