Most prospective medical school students set out to become doctors because they want to heal the sick, often forgetting that patients, young and old, sometimes die. Death is a very real and natural part of medicine that you will not only face, but also need to learn how to handle.
Before you start med school, consider how you might care compassionately for a dying patient and how you will cope with losing patients. Although some specialties may be more insulated from death than others, all will be touched by death beginning in med school.
During the COVID-19 pandemic, many premeds had experiences with family or friends’ families when they were unable to be with the loved one at the time of death. This was extremely hard on everyone involved. Time to grieve together is important to us as human beings. Fortunately, we have moved beyond the
pandemic and families are again allowed to be with their loved one.
However, there will be times a very ill patient asks the medical student to stay with them, especially if they are alone. Perhaps they want to talk or to pray. This can be surprising to the student but is really a compliment. They are feeling they can trust you, the student, and believe you care about them. This positive connection can come from the fact that you have spent more time with them while they have been in the hospital.
At some point during the conversation, you may want to ask them if they are fearful. If they believe they are near death, they may say that or that they simply don’t want to be alone. Your assistance comes through listening and asking them to share their thoughts and feelings.
Acceptance of them and what they are saying during this open conversation will help you and your team learn how best to help them. Medicine is not all science. Caring is a huge part of our profession.
Some physicians – very few in my experience – look at death as defeat and cope by emotionally running away from dying patients. For example, in the inpatient setting, they may visit the patient less often or avoid contact altogether.
Patients who die quickly in the intensive care unit may have nurses helping them make a final call to their family, if they are awake and aware. During COVID it was tremendously difficult for doctors and nurses in hospitals to go through this process repeatedly with their patients and led to feelings of demoralization for some.
Our daughter in Southern California was devastated after losing four patients to COVID-19 the same day. I never experienced that in my long career and wonder how I would have handled it and who I would have called on for support.
To keep functioning for the next patient, one must find ways to cry, grieve, share and keep moving.
In the outpatient setting, a doctor uncomfortable talking about death might recommend a longer time between visits or, rather than suggest a follow-up appointment, wait for the patient to request one. This coping strategy makes patients feel abandoned. However, most doctors are sensitive and some go to the patient’s residence or nursing home to say their final goodbye.
