Loss Hurts

{Serra Cross Park, Ventura, CA}

Every bit of me is fighting not to lay on the couch and immerse myself in reality tv to distract from experiencing the emotional distress of a recent loss. Doctors grieve the loss of patients.  I have grieved.  Unfortunately, the grief process is all too familiar in my line of work.  In fact, tears stream down my face as I type this because I know I have to acknowledge my grief rather than having shock, anger, sadness, and a whole mixture of emotions take control of me.  After receiving a call from the coroner’s office earlier that day, I drove home dazed and missed the entrance to my voter polling place…three times.  And I almost got in an accident.

The worst part is knowing that suicide happens too often.  The second worst part is a combination of feeling horrified, sorrow for my patient’s family, and disbelief (what did i miss? what did i do wrong?), wondering if there’s anything I could have done to prevent it.  But worst of all is to think of the depths of severe, emotional pain that my patient must have experienced to reach that point — no words can describe, and nobody can empathize with my patient’s despair unless they’ve been to a similar dark place before, or know someone who has.

Which is perhaps one of the reasons why there are barriers to change the perception of mental illness — do we distance ourselves so much from those diagnosed with mental illness that we can not acknowledge, empathize, or even begin to understand that suicidal thoughts are symptoms of a true, neurologic disease?  Or will society continue to turn a blind eye by continuing to believe that suicidal thoughts are feigned, a product of a hopeless mind, or a sign of weakness?

I can vividly recall the first time I lost a patient on the medical floor as an intern during my internal medicine rotation.  Cause = Septic Shock.  “Here’s where things went wrong and could have been prevented,” said an Attending physician when the case was reviewed.  I wanted to quit my medical career that very moment.  This time around, there is no Attending physician telling me what I did wrong — the voice is my own.  The voice is always there, and I want to quit.  I want to isolate and lay on my couch the entire day, but I can’t.  I want to cry when I’m in clinic each time my coworkers kindly ask “how are you?” but I hold back the tears.  I wish I could redo the last session with my patient, but instead, specific moments from our final conversation replay in my mind.  It’s not until now, as I type, that I remember my patient’s last words to me as she gave me a hug on the way out.  Touching words I will never forget and reinforce why I need to keep going.