Recently, I’ve found myself dwelling on the past. Maybe it’s just a phase, but I hope it’s a sign of maturity, that I’m moving into a new stage of my life. Usually, I find myself thinking about a dreary February day I spent in Toronto. I was there for my grandfather’s funeral. I can’t recall much because I was seven. However, there are few things I remember: heavy, gray clouds smothering the sun, the gloominess and gray scale of a suburban Toronto cemetery, and the hoards of somber and unknown people, all lost to the sadness and reverence of those final moments.
I also remember my mom and grandmother crying — the first and only time I had ever seen them cry. Tears rolled down their faces, like never-ending waterfalls, but what I remember most was the sound. It was like a thunderstorm on a humid day, intense and frightening at first, but slowly receding away. It was an incredibly cathartic moment; grief of the highest order. In their faces, I could see the memories of my grandfather, and the realization that there would be no more. It was the end of something — an innate human desire, the craving for a meaningful relationship. The only other thing I remember is that I didn’t shed a single tear. Like my mom, I was devastated, but I just couldn’t cry. I’ve regretted it to this day.
I’m not emotionally shallow, but I sometimes wonder whether grief is an emotion that I’m comfortable expressing or whether I should express it for the sake of my patients’ families. On one hand, emotion shows that you truly cared about the patient. On the other, suppressing emotion can show that the doctor is in control and fully focused on saving that life. To be honest, I don’t where I stand.
When I look back on the day of my grandfather’s funeral, I think I felt too vulnerable to grieve in that moment. Or maybe it’s because I was too naïve to understand what was happening, to grasp the finality of it all. Maybe I didn’t know how to grieve. And maybe it doesn’t matter; I’m not seven anymore. Maybe now grief is something that I’m mature enough to express, but no experience since that day has required me to grieve in such a manner. There’s something to be gleaned from these memories though. Maybe somewhere in there is the key to unlocking the expression of my emotions.
The other day, my medical school sent out this year’s match list. As I looked it over, I became more and more nervous. I didn’t want to see my name on that list in three years, slotted next to some specialty I didn’t want to do. But how do I choose the right one? Most first years have no idea what path they want to pursue, and I think that’s why I’ve been reexamining the past, attempting to get some semblance of whether I want to know my patients as a set of symptoms and diagnoses or truly understand who they are. Do I want to know the names of their children? Do I want to know their guilty pleasures? Do I want to know the number and names of their pets? I know that some patients will die, regardless of my efforts; that’s just the nature of life. And when they pass, having an emotional connection will make their deaths harder for me.
Despite this, I recently find myself wanting a deeper connection. I want to be able to discuss the score of last night’s basketball game and be able to ask them how the rest of their family is doing. I know the future will hold many more of those dreary Toronto days, but I think that I’ve grown up enough to be able to express my sorrow.
Recently, I heard of a doctor who has been completely desensitized to death. He doesn’t, at least outwardly, express grief. Maybe he feels too vulnerable to deal with the rawness the experience. Maybe he still hasn’t learned how to grieve. In one instance, this doctor found out that a patient had died. In response, the doctor just noted that he had an early lunch and continued with his day. I understand that for some people, humor is a coping strategy, but within the confines of a healing environment, gallows humor feels a bit callous. When a patient dies, I want to feel something. I want to attend their funerals and be like my grandmother and my mom. I want to respect the sanctity of life through death. I want to commemorate the end of not only a professional relationship, but a friendship. I don’t ever want to forget that my patients are so much more than a set of symptoms and diseases; they’re regular people, just like me.