I review the 5 Stages of Grief with my patients all the time. Yet, no matter how many times I review them, nor how many patients or people I lose in my life, experiencing these stages never gets easier nor avoidable.
Stages of Grief:
- Shock/Denial
- Depression/Sadness
- Anger
- Bargaining
- Acceptance
The following was written last week:
Today, I shall focus on shock/denial. Why focus on the shock/denial stage? I received a call from the medical examiner (aka coroner) today. I hold my breath each time I answer my office phone in fear that the medical examiner’s office is on the other line. The worst sentence to hear upon answering the phone is “Hi doctor, this is (insert name here) from the medical examiner’s office.”
My biggest fear became a reality today, yet again.
Currently, I am in the shock/denial phase and I’m coping by intellectualizing (a defense mechanism that many of my colleagues employ to deal with difficult news; mostly because I’m more comfortable processing the loss clinically rather than emotionally at this point, hence, the reason I am focusing on writing a blog post that teaches the stages of grief), carrying on with work, and going about my day, with the occasional few tears and blank stares when I have downtime. These moments of sadness are periods that I try to avoid, especially after glancing at my fully-booked patient schedule. According to the medical examiner, “cause of death is not known, the toxicology results are still pending.”
Each and every one of us go through this phase when we experience loss. I blogged about the subject of grief recently when I lost a patient to suicide two months ago. I am aware that my demeanor is currently “off” because I’m quite tense and impatient right now as well. I might be going through the motions of a regular day, but in no way am I taking this loss lightly. I know the anger stage will approach soon. For me, the worst stage is sadness/depression because I generally want to isolate and hide.
The following was written today:
One week has passed since hearing the tragic news about my patient. I enter the clinic, greet my usual “good morning” as I observe everyone going about their busy day as normal. I enter my office and suddenly have a desire to punch my computer as it takes forever to reboot. I settle for slamming my palm against the keyboard instead. Note that this is my usual morning routine, minus the angry/”I wanna punch something” part. The anger stage is here.
I see my first few patients and notice a decline in my usual empathetic statements, my mind drifts more frequently, however, I remain fully aware of my thoughts and am able to re-focus. The 20 minutes that I have with each of them is their designated time and I must not let my grief impact any medical decision. I take my lunch break and run into one of the therapists, who was also involved in my deceased patient’s care. I decide to open up about the struggle I’m having today, in hopes that we can provide comfort and support each other during this difficult time. Instead, I get a remark that pisses me the hell off, or at least that’s how I interpreted her curt comment. I essentially wanted to tell her she was an insensitive idiot and to f*** off, but I held my composure. I normally wouldn’t be bothered by such a comment, but I’m clearly more irritable than usual. I let it go and tried to have compassion for her especially since she might be grieving as well, or thought that perhaps she’s a cold witch and doesn’t care, then thought that perhaps I misinterpreted her comment. Perhaps I feel that nobody understands, and maybe no words can make me feel better at this moment anyway.