Hello and welcome back to the podcast and today we’re going to talk about a tough subject: dealing with loss. And I specifically picked this topic because a lot of you women in medicine are experiencing the loss of your patients, the loss of your colleagues, and during COVID, we’ve all experienced the loss of friends and family members which makes going to work sometimes that much harder. We have to deal with our own personal losses. And so this has been a really challenging period and I know people have a lot of questions about what to do and how to manage so that you can keep going back to work and doing the work that you love. So I’m here to answer some of those questions today and hopefully share some tips and wisdom that’s going to help you do your job given all the losses that you’re experiencing in lighter, hopefully more positive way.
Sometimes when people experience loss, they go through a roller coaster of emotions. In fact a psychiatrist by the name of Elisabeth Kubler-Ross mentioned that there are five different emotions that people experience as a result of loss.This was inspired by her work with terminally ill patients and is written about in her book On Death and Dying.
The first thing that she talks about is denial. So sometimes when we experience something very hard and challenging we try to just convince ourselves that “this can’t be happening. It must be a mistake. There’s no way that this is going on” and that’s because it’s really hard for us to digest the information. We’re trying to protect ourselves so it makes sense why we go into this denial. But we can only stay in denial for so long. Then what she talks about is that sometimes we then become angry when we realize that this is actually happening and we’ll ask questions like “why did this have to happen to me?” Or “what did I deserve this?” as if this is because of something that you did, right?
And when it comes to your own patients, you may not be asking that specific question but you might just be angry about how the hospital didn’t have more resources to help your patients, how somebody could have done something more and they didn’t, and so you’re looking for somebody to blame perhaps because it feels just so overwhelming to have lost your patient.
Another one of the five emotions that you might be experiencing is what she calls bargaining and that’s where you start to have these conditional statements that you say “if I could trade my life for theirs, I would” or” if I could bring them back I would do X.” You’re coming up with some sort of thing that you’re vowing to do or you promise to give in exchange for reversing the results.
Then one of the things that people experience is depression where they have already accepted the fact that they have this loss and then they might start asking questions like “then why even bother with anything? What’s the point of going to work? I’m just going to see more people dying. What’s the point of going on with my life? I’m going to just die anyway.” Those kinds of questions. And if you are finding yourself asking those questions it’s a sign that you are depressed and so you need to take care of that. You need to get some support, get some help and really you’ll know when you’re on the other because you’ll be able to feel like yourself again. You won’t be asking those kinds of questions.
And finally she talks about acceptance and that’s where you just embrace the mortality of life and you say to yourself “it’s going to be okay. Even though I’ve lost this person or even though this has happened, I’m going to be able to continue with my life. It’s not going to be the same. It’s going to be different but I will survive.”
One of the questions that people sometimes ask when they’re grieving is “How can I stay positive when there’s no hope?” And what are you going to offer is that death and loss can be very very challenging especially when there are very strong attachments, especially when it’s sudden or unexpected or if you feel like the circumstances aren’t “fair.” But what I want to have you consider is that there is always hope for something good to happen in the world. Even when bad things are happening there is always that 50/50 balance of bad and good things happening. I know it’s so easy for our mind to focus on the negatives so I would encourage you to think about “if there was hope, what would that look like? What can I be grateful for in my life given all the circumstances — both the good and the bad?”
Another question people ask when they are coping with loss is “What’s the best strategy? Is it embracing it or ignoring it?” and again, ignoring it is kind of like that first step that Elisabeth Kubler-Ross talked about, which is denial. “I’m going to pretend like it’s not really there” and that’s never really a good long-term strategy because it is there and we have to deal with it. So what is embracing it look like? Ideally it’s about getting to that place of acceptance that we talked about where you’re able to say “It is really unfortunate and it’s so incredibly sad that this person has died or that the circumstance has happened but I have to accept it and have to learn how to move on with my life and it’s going to be different and it’s not the way perhaps I wanted this to go but this is not something that’s in my control and me pretending that it doesn’t exist does not change anything.”
Sometimes people ask “Is anger a right response to grief?” and as we talked about anger is one of the responses that we have on that emotional rollercoaster. It’s completely natural for you to be angry. So don’t refrain or don’t try to prevent yourself from feeling your emotions. Just know that they’re there to serve a purpose. They are helping you to get through this process of loss and that you will get to the other side. Everything that you feel is temporary.
Another question is “Can crying help you resolve grief?” One of the things that I’ll say about this is that crying is a fabulous outlet for your feelings. And sometimes, as you’ve probably experienced, when we cry it’s a great release and we feel later afterwards. So everybody has a different way of coping with things that are difficult. For some people it’s going to be crying. For other people that might be hitting a pillow because you’re angry. For other people it might be just doing some sort of a mental cleanse like doing some meditation or maybe getting some social support. It could be journaling. There’s a whole slew of options for you in coping with loss but I think ultimately have to find what works best for you.
And then lastly people ask, “Can we prepare ourselves for the losses we might have to tackle in the future?” And this is a really good question for you all to ask yourselves because you probably see more death than the average person. In order for it to not overwhelm you, this is a really good question to wrap your head around. So I like to think about mental preparation whether it’s for a losses or for anything else as having compassion where you feel something for that person but you’re not necessarily feeling their pain and I’ve talked about this on a previous episode on my Optimize Your Life podcast, the difference between compassion and empathy and what I would really suggest is that you find a way of understanding the loss and what it means and feeling the feelings of sadness if that’s something that is coming to you — that’s totally natural and healthy, but not getting stuck there. And then really embracing the same idea that life is fragile and we never have guarantees about how long we’re going to live. And everyday people die before their time because of accidents, because of disease, because of different things and it is unfortunate but it’s also inevitable and because this is the sort of thing that happens to everybody, you are bound to know somebody who is dying due to cancer, due to heart failure, due to stroke, due to violence on the street. We are all going to know somebody like that and I think for women and medicine in particular you’re going to see much more of that than the average person so it’s really important for you to brace yourself and to not let it overtake you.
People often ask me as a psychologist, “How can you spend all day talking to people about their problems? Doesn’t that just overwhelm you?” And the reason they ask this is because they think about what it would be like to just be filled all day with conversations about negativity. But that’s not how I look at it at all because if I did I wouldn’t last in this career. I don’t take people’s problems home with me. I don’t dwell on these things. I look at my job as somebody who’s there to help people. if they’re struggling I’m going to give them a lifeline. I’m going to throw them a rope and help them get out of a ditch. But does that mean that everything I do works? No, it doesn’t, but then I just think about what else can I do to help them. So my focus is just on doing the best that I can and then it’s really out of my hands. It’s up to them whether they use the tools that I teach them, whether they do the homework that I assign them. And obviously for you it’s very similar. You can do all the best things but ultimately you may not have control over the outcomes. You don’t know if the hospital is going to give them all the things that they need in order to live and maybe sometimes you give them everything but their body just gives out. And that’s also not something that you have control over. so you have to find a way of staying in the game without getting overly emotional and attached.
So now I’d love to share some quotes that I found about grief that I think are really helpful in thinking about this subject. So Rumi the poet said, “Don’t grieve. Anything you lose comes round in another form.”
I also found a quote by somebody named Cassandra Clare from Clockwork Prince and she says, “They say time heals all wounds but that presumes the source of the grief is finite.” And I really can relate to this because I have a friend who lost his partner due to suicide and he is absolutely devastated. He’s very depressed and he really doesn’t care about living his life. He’s trying to just get by and he’s really just dropped out of life. But what he’s found over time is that it’s getting a little bit easier, that it’s not as painful as it was initially. And so while his life has forever been altered by his partner’s death, he’s also finding over time that he can breathe again and that maybe, not yet, but maybe in a year or two or five he’ll find himself again and he’ll rebuild his life. So for everybody it’s going to take a different amount of time. I think people have different levels of resilience and people have different levels of willingness and motivation and coping skills, so all of this is going to factor into how you are going to fare.
Leo Tolstoy said “Only people who are capable of loving strongly can also suffer great sorrow, but the same necessity of loving serves to counteract their grief and heals them” and I just love that. I think it’s so beautiful and I hope that gives you something to hold onto.
Lastly, what I want to share is that sometimes people don’t know how to help you when you’re grieving and it can feel a little bit awkward. It’s really up to you to know what you need and instruct them on how to best help you and sometimes it’s hard because you might not know what you need either. So if you know somebody who has experienced a loss and you want to help them, perhaps instead of offering to have them call you if they need you, offer a hug and offer to be there for them in this moment and check in frequently.
And if you’re the one experiencing the loss, then you probably would benefit from hearing from people who have also experienced a similar loss because that can be very comforting. So talk to your colleagues, talk to your mentors, talk to other friends, family, anybody who has experienced a loss similar to your own.
What I want to leave you with is that life needs to be lived fully and that loss is part of that. So in order for you to experience the full range of emotions which include joy on one end of the spectrum, we have to experience grief and loss and sadness and so don’t try to stuff your feelings, don’t feel badly about experiencing those feelings. They are part of the human experience and just know that they are temporary and that the more you build up your mental resilience the easier is going to be to manage with losses in the future.
I want to take this opportunity to thank you for all the amazing work that you do and for saving lives every single day. While you may not be able to save everybody, I think it’s important to acknowledge that you’ve dedicated your life to helping humankind and that you have brought so many people together and allowed many more people to increase their quality of life because of your work.
I want to invite you to join my Tribe to Thrive so that you can be part of my community where I can continue to nurture you through daily emails, trainings that I put on, and other amazing products and services. So go to www.drsharongrossman.com , join my list and I’ll see you on the inside.