Bipolar Advantage

Being bipolar without disorder.

What Depressives Can Teach Doctors About Grieving

Doctors' inability to handle or acknowledge grief is negatively affecting care.

My daughter Kate is in her fourth year of medical school and is well on her way to becoming a very caring doctor. Her greatest gift is the ability to connect with people, which thankfully is being recognized in the hospital settings as an asset. She creates strong bonds with her patients and their families by communicating how much she cares about them. Among so many other admirable traits it is the one that makes me the most proud of her. It has been her greatest gift for as long as I can remember.

The ability to form strong emotional bonds is not without tremendous risks though. It hurts her deeply when a patient that she is involved with dies. It is a testament to her awareness, understanding, and strength that she can perform even on days when she sees the worst aspects of the medical profession; in spite of their best efforts, they cannot save everyone. Kate has grappled with that many times and come out the better for it. 

As her father I like to think that I have something to do with Kate's insights. We discuss the topic often. As someone who deeply understands depression and has learned to function fully while in the most intense states, I know my insights have helped Kate to develop the skills in her own life. I believe such skills are the key to her success and will help her to stand out amongst her peers.

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A recent study about how doctors are affected by grief was published in the Archives of Internal Medicine and was described in an article in the NY Times. I read both reviews with great interest and was very excited that it confirmed what Kate and I had been discussing. I have worried that the grief that Kate experiences might overwhelm someone without the insights and support that she has. This is exactly what the study was about.

A few highlights really stand out for me in the NY Times article: "Not only do doctors experience grief, but the professional taboo on the emotion also has negative consequences for the doctors themselves, as well as for the quality of care they provide... The impact of all this unacknowledged grief was exactly what we don’t want our doctors to experience: inattentiveness, impatience, irritability, emotional exhaustion and burnout... Even more distressing, half our participants reported that their discomfort with their grief over patient loss could affect their treatment decisions with subsequent patients — leading them, for instance, to provide more aggressive chemotherapy, to put a patient in a clinical trial, or to recommend further surgery when palliative care might be a better option."

But, one point in the article caught my attention — "... no one wants their doctor to be walking around openly grief-stricken."  I am afraid that they missed a critical point; there is a huge difference between being "openly grief-stricken" and the ability to perform. Those of us who have Depression IN Order know how to experience intense emotions without letting it affect our performance. Only those who have not yet been taught how to function are debilitated by it. I want my doctor to be so concerned with my health that she is "openly grief-stricken." It shows that she cares. I don't want her to lose her ability to give the best care possible, though.

The NY Times article ends with a tremendous ray of hope: "To improve the quality of end-of-life care for patients and their families, we also need to improve the quality of life of their physicians, by making space for them to grieve like everyone else." It opens up the possibility that they might learn from us. We depressives can teach them how to grieve while still performing their critical duties. Of course we will need to teach them how to grieve differently from "everyone else," but perhaps the doctors can then teach their patients that grieving is an important part of life that does not need to be in disorder.

Tom Wootton founded Bipolar Advantage with the mission to help people with mental conditions shift their thinking and behavior so that they can lead extraordinary lives.

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