Written By Dr. Tejal Lathia
When the team contacted me to write this month’s blog on dealing with the loss of a patient, I laughed to myself. I realised that now after more than 2 decades in practice, I can finally answer this question. I wish someone would have sat me down as a young medical student to tell me how to deal with this situation. When we train, we are made to feel like we are responsible for the life and death of every person in our care. That we can snatch people from the jaws of death by our heroic efforts. And this weighs heavily on us.
Somehow, I have muddled through the years to arrive at my own way of dealing with the loss of a patient.
Firstly, let’s examine what we feel when we lose a patient. I think the overwhelming emotion early in my career (as a fresh graduate working at a small rural hospital) was guilt and shame at somehow not doing enough for the person, for failing to save him or her. Constantly going over each step, double guessing each decision, mindlessly playing the whole scene on repeat.
Then came a phase of numbness, no emotion whatsoever, just carrying on without a break in step. This usually happens in residency because people are dying everyday all around you, especially when posted in ICU. There is just not enough time and space to process anything, just enough time to eat, sleep, repeat.
Then came the current and final stage. After a lot of self-work, introspection and reflection, I slowly started to come to terms with my limitations as a doctor, acknowledging my own very common humanity. Exploring the concepts of karma, rebirth in spiritual literature on death and dying – The Bhagvad Gita, Buddhist texts, books on rebirth (Dr Brian Weiss)… I have come to understand that every human being has a finite lifespan. When its time to go, its time to go. No human force can interfere with this inevitability.
This does not mean that we do nothing and let people die. Our job is to do our best, but the outcome is not up to us. So many times, we are sure a patient won’t make it but they do. At other times, we are sure someone will pull through but tragically lose their battle with death. Equanimity in the face of both.
Our profession does not leave us the luxury of dwelling on a particular patient as there is always someone else who needs our attention. This sometimes pains me as it seems that we haven’t honoured the passing enough, that somehow the person deserves more than our fleeting attention.
Now, when a patient under my care dies, I check with myself if I did my best. Say a small prayer for the soul to rest in peace. Feel compassion for the loved ones left behind. Feel hope that the person has passed on to their next life and it is not really the end. I also experience sadness as a death always reminds us of our own mortality and the suddenness, the unpredictability of death.
The truth or reality is that we are merely a blink in the face of evolution, a blip in this infinite universe. We are simply not important enough. This leads to a great lightness when we live our life because seen in this perspective, nothing we do matters all that much. All the things we agonise over – success, fame, making a name, leaving a legacy – seem irrelevant. We are all going to go into oblivion one way or another.
So, we live our life with joy, peace and compassion for all living beings.
Death really is the greatest teacher, it teaches us how to live.