Doctors and death: A Dose of Grief
Since the global pandemic of 2020, the mental wellbeing of medical professionals has become a subject of focus. According to the Association of American Medical Colleges, nearly 80% of doctors have experienced a distressing patient event in the last year, and many go on to suffer from depression, anxiety, and PTSD. Furthermore, in July 2020, a study published in the journal ‘Occupational Medicine’ showed that almost 50% of intensive care staff showed signs of PTSD, suffering from anxiety and depression ‘worse than combat troops’.
Could part of this trauma be caused by a lack of death literacy among newly trained doctors? We spoke to Paris and Isabelle, Melbourne University medical students, about how unprepared they felt to deal with the inevitable situations that would occur around the deaths of patients and how they decided to face this issue.
How can we learn to confront death and dying?
At the end of 2023, our first clinical placement was fast approaching. Although grief, dying, and death is an inevitable part of healthcare (and life), we felt unprepared to face death and its consequences. We didn’t know how we’d empathetically and compassionately face a dying patient and their grieving family, particularly as we learn to become the professionals delivering the news.
There’s only one death and dying course hosted by the University of Melbourne’s Doctor of Medicine degree, though it’s an elective not every student will have the opportunity to study. Even having taken the class, the magnitude of inevitable encounters with grief and dying felt overwhelming. This is particularly so when all we hope for is to serve patients and their families effectively, kindly, and compassionately.
If we felt this way after some exposure, how might other students feel with no death education at all? How will we manage as interns and residents when we graduate medical school, and are expected to lead these difficult conversations? Will we feel capable of completing the necessary administration tasks? Who could we lean on for support in times of loss? Will our colleagues look down upon us if we are struggling?
A Dose of Grief
While much of medicine involves learning ‘on the job’, we believe that a solid foundation in death literacy, informed by core knowledge, exposure, and support in our early careers, would better prepare us for future practice. We wondered how we could contribute toward developing this foundation, and in doing so, how we could make death education accessible to all.
In response, we decided to create A Dose of Grief (ADOG). ADOG is our effort to change the culture around death and dying in medicine, through:
Educating and inspiring clinicians to become ‘death literate’;
Providing students with hands-on education opportunities to support upskilling;
Destigmatising death and dying through encouraging transparency and dialogue;
Building a network of students and clinicians willing to receive and provide support to others; and
Challenging judgments ascribed to death in healthcare, including that death is always a failure.
Our website is a hub for clinicians and students to access resources including academic articles, support services, and media recommendations. Our podcast is focused on making conversations around death and dying less taboo, encouraging doctors to be open and honest about their experiences and struggles in medicine. We interview doctors about a ‘death that changed them’, and their experiences in receiving support within and outside the hospital system.
ADOG has allowed us to connect with many exceptional clinicians, such as Sir Albert Aynsley-Green. Like us, he is on a mission to encourage healthcare workers to come face-to-face with death, dying, and grief, and to take ownership of our role in putting ‘compassion’ back into compassionate care.
We have a responsibility to our patients to honour their lives and their deaths. We have a responsibility to our patients’ families to provide support and clarity in their grief. We have a responsibility to our peers, and to ourselves, to ensure we have the resources, skills, and courage to compassionately confront death and dying.
Paris and Isabelle
Melbourne Medical Students
