In a profession where death and dying ‘are part and parcel of the work,’ study author Leeat Granek said, grieving is mixed with ‘feelings of self-doubt, failure and powerlessness that come from the idea that doctors are responsible for their patients’ lives and for making their treatment decisions.’
In South Africa, more than 45 000 people die of cancer every year.
For the study, 20 oncologists described how they dealt with grief, and its effects on their professional practice and personal lives. The study was recently published online in the Archives of Internal Medicine.
‘The issue with doing oncology is that you walk a very fine line,’ one doctor in the study said. ‘If you get too involved with your patients you can’t function because it’s too much (of an) emotional load to bear, and if you get too distant from your patients then I don’t think you’re being a very good physician, because people pick up on that.’
Granek, who is a post-doctoral fellow at the Hospital for Sick Children in Toronto, Canada, said that oncologists also take the grief home with them. Although some doctors ‘compartmentalised’ in order to function, others had difficulty sleeping or enjoying time with their family. Several oncologists said they cried on the way home in their cars. But feelings were kept private or submerged.
But the study reported positive reactions, too. Some physicians found they had a better perspective on life from frequent exposure to patient loss. And some felt motivated to give better care.
‘Losing any patient is difficult,’ said Dr Len Lichtenfeld, deputy chief medical officer at the American Cancer Society in a HealthDay News report. ‘But there is no time to grieve. You have a moment or two to reflect and then you’re on to the next patient who needs your help.’
An accompanying journal commentary described how one institution is dealing with the situation. Since 2008, the University of Rochester Medical Centre in Rochester (United States) has held staff-support meetings – mandatory for oncology fellows – where practitioners are encouraged to discuss their experiences with patient loss and grief.
Sources: HealthDay News, World Health Organisation