It is hardest to talk to somebody mourning the sudden loss of a loved one. You are faced with questions that demand exact answers, but no explanation is ever enough, no course of action justified. Grief takes away all reason, leaving only an impenetrable wall of shock and anger. You are not even sure if it is appropriate to say sorry; you know that you did the best you could, and still failed.
As your patient lingered between living and dying, inasmuch as you wanted to offer family members hope, you also wanted them to understand that there is, and will always be, a limit to what you can do as a physician.
You just cannot save them all. Neither an apology nor an excuse, it’s just the way things are. In this age of gene therapy and molecular medicine, countless questions on the natural course of diseases remain unanswered by science. Why this patient? At this time? Despite everything that has been done? Death prevails, and you are reminded of the fragility of human life.
You put yourself in their shoes, to try to see things from the point of view of grief. Removing the science of increased intracranial pressure, cerebral ischemia, mechanical ventilation, inotropic support, and multi-organ dysfunction from the picture, all that is left is a patient, husband or wife, father or mother, son or daughter, brother or sister, friend or beloved, taken away with an abruptness that magnifies the pain many times over. You begin to understand, so you bear their every word, and respond with silence.
Do they realize that you are also wounded by this loss? What wakes you up each day is the hope that your patients live longer, happier, and more meaningful lives. Conversely, their suffering becomes your burden, and their death, your failure.
No doctor would want his patient to die.
You can always objectify the circumstances and shield yourself with apathy, but that would take away the essence of what it is to become a doctor. To heal is to comfort, outright impossible if you nullify all emotion.
At the end of the day, you can only take so much grief. You end up scarred, but that is the price you pay for choosing this path. You pick yourself up and move forward, otherwise you become unfair to the other patients who entrusted their lives in your hands.