As humans behind the white coat: On challenges for medical students and young doctors acknowledging own emotions following patient death

Abstract

Doctors, as mere humans behind the white coat, are expected to experience an array of strong emotions following patient death. Even for experienced clinicians who are used to the routinization of death in hospital settings, patient death could still be emotionally exhausting and difficult to deal with. In 2008, a nation-wide survey in the U.S. involving 1500 obstetricians (Gold et al., 2008) reported that over 75% respondents considered handling stillbirth cases to take tremendous emotional toll, and almost one in every ten doctors considered giving up the specialty. Not surprisingly, these raw and spontaneous grief reactions could be more predominant in medical students. They often contain elements of trauma such as helplessness, guilt and doubt of personal competence, all of which could shadow young doctors in years to come. While doctors grieve for deceased and dying patients, little about recognizing physicians' own emotions is taught in medical schools worldwide. In medical education, there has been a 'conspiracy of silence' toward physician grief. In recent years, scholars are becoming more concerned about the extent to which such 'conspiracy of silence' medical education might have encouraged young doctors to take suppression of physician grief to be a tacit expectation. In the absence of proper training in medical education to engage in this potentially distressing emotional side of medicine, young doctors could develop maladaptive grief-averse habits such as dehumanizing the deceased person into a purely biomedical object or sugar-coating bad news. End results could be substandard care, heightened professional stress, and worse still, a grief-averse culture in medicine where young doctors collectively, willingly take part in disenfranchising their own grief when facing patient loss.