The Brutal Truth: Coping with Emotional Agony And Death As A Doctor
Dr. Shuba Srinivasan narrates the truth behind doctors facing emotional stress and agony over the loss of patients
Often, people presume that doctors remain unfazed on the occasion of their patient’s death and chalk it up as another head count. But the truth is, no matter how many deaths we might have witnessed over the years, the loss of a patient- especially that of a young person- is always devastating.
Not long ago, a 21-year-old girl was admitted to our hospital and supposedly, had generalised oedema accompanied with body aches. The pain and discomfort had started insidiously and had not diminished in its intensity for nearly two years. At the same time, she has also been consulting several doctors, but all were unable to conclude on a definite diagnosis. By the time she approached us, her health had deteriorated considerably and she was critically ill. Post examination, we found that she had an active SLE with Lupus nephritis. She was losing so much protein from her kidneys that she had become oedematous along with ascites and pleural effusion. She was put on high dose steroids as per protocol in the hope of yielding more significant improvement.
However, on the third day of treatment, she developed severe abdominal pain. On further evaluation, she was found to have developed pancreatitis. We were all very devastated with this diagnosis. Here, there was this young woman aspiring to cherish the gift of life, yet; bound to deal with a growing uncertainty of facing multiple life-threatening complications, piling up one after the other. And to add to the whole tragic tale, her family had decided to take her home, since she was uninsured and also due to the mounting medical bills that were hard-pressed to afford.
The hospital was willing to help them by subsidising her treatment but the family was adamant about taking her home to see her mother. And therefore, she was discharged against the conventional medical advice. When we called them the next day to enquire about her status, we found out that she had passed away after reaching home. She had spent time with her mother. They had their moments together; their final moments. I could imagine the devastation and grief of the parents at losing their daughter, so early in her life.
It took me a while to get over her death. But the grief, it’s always there, like an old wound that aches when it rains. It is still one of the most vivid experiences that hit close to home. What if she was one of ours? What would have happened if I was in their shoes? I am sure that these thoughts cross every doctors' mind irrespective of the number of fatalities that we encounter in our career.
Just peel away all the "titles" and we'd all be the same -“Human beings”!
Dr. Shubha Srinivasan MBBS, DNB, FRCP is the Professor and HOD, Dept. of General Medicine at DM-WIMS