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Elizabeth Cooney is a health reporter for the Worcester Telegram & Gazette.
Boston Globe Health and Science staff:
Karen Weintraub, Deputy Health and Science Editor, and Gideon Gil, Health and Science Editor.
Short White Coat blogger Ishani Ganguli
Short White Coat blogger Jennifer Srygley
Wednesday, September 26, 2007
Journal asks: After a patient dies, how do doctors deal with their emotions?
It was more than 30 years ago, but Dr. Katharine Treadway (left) vividly remembers answering her first "code" call to revive a hospital patient.
The resuscitation attempt failed, and in this week’s New England Journal of Medicine she recalls what it felt like, as a freshly minted intern, to simply walk away from a life that had just ended.
“Someone had just died. But we all behaved as though that was not at all what had happened,” she writes. “We learned to bury our fear of death in an avalanche of knowledge. … And for good reason. We could not do what we do – take responsibility for the lives of our patients – if we were aware, minute to minute, of the true significance of what we were actually doing.”
The journal is publishing Treadway's essay to spark an online discussion, which the Boston-based publication calls Perspective Forum. Its physician readers are invited to write about how they cope with the emotions they put away while meeting clinical challenges.
Treadway, a Harvard Medical School faculty member and primary care doctor at Massachusetts General Hospital, writes that many doctors have private rituals they observe whenever a patient dies -- she says aloud, "May choirs of angels greet thee at they coming" -- but they rarely share them.
White Coat Notes asked Treadway what she would like to hear from readers, why she chose this topic, and what she teaches medical students about it.
What do you hope to hear in the forum?
What do you teach medical students about emotions?
What about situations like the code call?
There’s this tremendously fine line that we have to walk in terms of dealing with acute life-threatening situations in which you absolutely have to stifle your emotions. You can’t fling your hands into the air and say, 'Oh my god.' That wouldn’t help anyone.
How do you find that middle ground?
How about your own work?
Being a primary care doctor, I take care of my patients’ children, or their children’s children, or in one case, the great-granddaughter of my original patient. In addition to teaching medical students who are so eager and idealistic, it’s just so renewing. I feel very lucky.