Psychiatry

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.

16 thoughts on “Loss Hurts

  1. This truly resonates with me, as I’m a therapist who also experienced the loss of clients to suicide. I can relate to the internal shame, doubts, and guilty feelings. Your message also gave me a vivid look into your journey of loosing patients, different factors and intensities that grief can present itself, and coping methods and motivation to continue making a difference despite the possibity of receiving that dreaded phone call. Thank you for sharing your personal struggles and growth in this difficult but much needed topic of discussion.

    • Hi Melina, thank u for sharing. Losing our patients is the hardest part of our job. I hope u had support and didn’t feel alone in the grief process. I’m sure you’ve made a difference in your clients’ lives. Thank u for the work u do.

  2. Thanks for sharing! Golf is a nice way to relax, Let me know when your ready. I am not that good so we can just go out and hit balls.

  3. Sorry for your loss and my condolences. I work in personal injury law and our clients come to us after a loss, either the loss of a loved one or of life as they knew it. On the surface, all we can pursue for our clients is financial compensation–that’s how the system works. But, for many simply knowing that someone will represent them through the many hurdles of the legal system is a more important part of their grieving process. They have lost, through no fault of their own, someone or something very important to them, The solace they seek is mainly that the justice system is open to them and takes their loss seriously.

  4. My comment didn’t convey what I meant to say. I recognize that our professions are quite different, and that the relationship between patient and psychiatrist is much deeper than a lawyer and client. I really feel your anguish through your words here, and my heart goes out to you for what you’re feeling. I am truly sorry.

    • Hi Tom, I think you play a very important role in your clients’ grief process. I’ve had several patients go through complex legal battles who feel a sense of calm and relief knowing they have a lawyer who listens and confidently represents them or their lost loved one…a relationship extremely valuable to help them heal. Thank u as always for your thoughtful comments and also for your condolences.

    • thanks for sharing! i find the readers’ comments interesting. the writer’s final line of having the “last laugh” shows how much insight she gained in therapy on the origins of her use of humor as communication style and defense. Though when it comes down to it, everyone’s underlying issues almost always stem from mom and pop 😉

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