"It’s not life or death." That's what most people tell themselves when there’s a blown deadline or livid customer at work. But what about people who actually deal with life-or-death situations as part of their jobs?
To help those of us with lower-stakes careers understand the human emotions behind medicine, doctors and nurses shared what it's like when the worst outcome occurs.
It can haunt you forever
"It changes you. You can’t help but grow to love your patients and their families. You're part of such an intimate, special part of their lives. But the whole time you build this relationship, you know in the end you're losing a special bond. Being so close to death made me realize how fragile and precious life is. I think it made me more afraid of death than most people."
-- Jessie M. Gill, RN and former hospice nurse, FlusteredMom.com
"I practiced cardiology for over 35 years. I lost several patients by way of human error... Short of the grief experience on the part of family members, there's nothing more humbling, numbing, and profoundly distressing. Nothing in my formal education or training could've prepared me for this horrific circumstance. It feels like being on a small deserted island with no hope of rescue [or] salvation.
"I retired from cardiology two years [ago]. It still haunts me, not only in my waking hours, but in my dreams... In retrospect, knowing what I know today, I would have second thoughts about entering the high-risk subspecialty of cardiovascular disease."
-- Steve Silver, MD
It's not exactly a part of the job you get used to
"I direct the Code Team Leaders program at Bellevue Hospital and see about 12 people die per month. Been doing this for years. It still gets to me; I still cry sometimes."
-- Jim Lebret, MD, assistant professor of medicine and director of Code Team Leaders at Bellevue Hospital
"Seeing someone die in front of you is a terrible thing. You realize the frailty of human existence, and at the same time need to gather the strength to move on, because the next person still needs you. You also have a responsibility to deliver the news in a clear, professional, and empathic manner to the family and friends of the deceased... It’s an experience I wouldn't wish upon anyone."
-- Joseph Glaser, MD, nuclear medicine physician
Feeling emotions is part of being a medical professional
"If there's a code on your unit, everyone runs to fix whatever the problem is. When some people pass, you feel a sense of relief because they had no quality of life. But death is sad either way. You don't want to be disengaged. The thing we talk about in nursing is the quality of care we provide. Are we giving good care for these people? I don't know how good of a nurse I would be if I had the capacity to be completely divorced from someone that I am caring for dying."
-- Marisa Mouton, RN
"It really is not different than the death of a friend... We form a very intimate bond with patients. These deaths are not sudden, and in many ways we are with them along the entire way. When they do pass, I mourn. I do not take time off from work, but my mood is more somber for some time."
-- Allen Kamrava, MD, MBA, FACS, colorectal surgeon
Then again, detachment can help provide better care
"It’s sad to say, but we do become numb to it over time. It's a protective mechanism for us. Working at a trauma center, we see a fair amount of death. The majority of times I see death at work, it's a very detached feeling. I don't see a person; I see a problem -- a respiratory problem, a heart problem, a bleeding problem. It helps keep me separated from emotions, which allows me to do my job better.
"I hate the fact that it blunts my emotions, especially toward family members or friends that are sick. But we do have to blunt our reactions to be able to function in the world we do. You have to be very fast and agile with the work we do in the emergency room.
"We are a cynical bunch of assholes, but we are very good at our jobs and it is to the detriment of our own person. Anyone who denies that is in denial. Nobody can see the shit we do and not be affected by it. Nobody can go into combat and come out the same person they were."
-- Luke LeBas, MD, board certified in emergency medicine at an urban level 1 trauma center
It's horrible, but experience helps you process it better
"Without exception, it sucks. It's remarkably like getting the wind knocked out of you. You want to have done right by the other person. It's never cut and dry, and it's always a little messy, but if anything, it makes me work harder due to [death's] significance. Part of it is work ethic, but I like to think the majority of it is being a good person.
"As you become more comfortable with your role and how you process your emotions, you get a little better at it. More mature. I think it always sucks, but you are better able to take it in stride and glean from it the meaning you are supposed to without over or underreacting."
-- Michael Dietz, MD working in primary care in the VA system
"It's definitely harder at the beginning, I think. We believe so much in everyone working together, relying on staff, nurses, different specialties all communicating. A lot of time something happens, and you feel like the patient shouldn't have died. It's not only that someone died, but your system didn't work. When that happens, it's like you failed.
"One case I was on was in trauma surgery. The woman was stabbed pretty badly. We thought we could revive her and worked for hours. We cracked her chest to open her up for surgery. We tried to stop the bleeding and used 50 pints of blood on her. In the end, she didn't make it.
"They left me with her and some needle and thread and I sewed her back up. That was really hard. After that was done, it was 4am, and it was time to see my patients at 5am. I was up for 35 hours that day. You never forget it. You realize you have to move on. But it never leaves you."
-- Denise Capps, MS, fourth-year medical student class of 2016
Death doesn't have to be all sadness and misery
"I used to be an ER doctor dealing with life and death on a daily basis, and death seemed like the enemy. Then I transitioned into palliative care and hospice, where I help people become comfortable with death.
"I now understand that death is a natural, inevitable part of the cycle of life. The end of a life should be honored and celebrated just like the beginning of a life, instead of feared. Incidentally, I helped guide both of my parents through terminal illnesses and was with them when they died."
-- Bob Uslander, MD
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