None of us wants to get burned or to feel cold to our patients and families. While that seems obvious, I appreciate the campfire analogy and story shared by Melissa Palmer in her recent blog post (and her less recent post on shame). It prompted me to make some connections between my experience, knowledge, and beliefs about medicine and my own moral character. Being aware of your own emotions, biases, and state of mind when you approach an encounter is sage advice. It is important for us to focus upon the patient and their loved ones without allowing our disposition to impose. We have a responsibility, a duty, to be there for them in their time of need. That is our job. Yet, it does not mean that we should disregard our feelings or that they are not important to the work that we do.
Self-care, personal reflection, opportunities to debrief, and participation in counseling are things that most of us could do more of. They are valuable opportunities for us to process our own emotions and grief. I say grief not just because of grief from our personal lives, but also the grief we hold for our patients.
While I know that I have felt shame for shedding a tear in front of a family of a patient who is dying, I also recognize that the underlying grief I experienced is because I care. It is because I am a human being. And I believe it is that vulnerability, as a human being, that allows us to connect deeply with those who we serve. It allows us to express empathy towards our patients and their families, and not just sympathy.
I am also reminded of the words of Cornell West, who teaches us that compassion comes at some expense:
“Compassion is a particular form of love… it’s always, like any form of love… there’s a certain death of aspects of yourself, and there is the emergence of other aspects of yourself that are now entwined with that significant other. So there is a new person, new being emerging out of that old person and old being that ought to be less narcissistic, less egoistic, and more concerned with the welfare of the other.”
I encourage you to not be ashamed of grieving for your patients. I still struggle with how my emotions are perceived by patients and their loved ones. Am I worthy of feeling loss for someone who I barely know? Does it diminish the love of family members for the patient? However, I now recognize that it is my grief, my vulnerability, that allows me to connect on a deeper and more meaningful level with my patients and families as fellow human beings.
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