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Lessons learnt from the loss of a baby The November edition of Academic Medicine contains an articulate and moving account of the death of a baby written by a Paediatric Resident, as an open letter to the mother1. She says: ‘Weeks later, I sat with my sister, who was seven months pregnant at the time. She mentioned that in some cultures it’s bad luck to decorate a baby’s room before he is born. Immediately I thought of you. I thought of a room painted the perfect shade of blue. I thought of walls lined with baseball bats and the blanket his grandmother made. I thought of perfectly coordinated outfits that would never be worn and a crib that would never be slept in, and my heart broke for your loss. Maybe it was selfish for me to grieve a loss that was so clearly yours, but I want you to know that your doctors do grieve.We grieve for the life that could have been, for your shattered dreams and dashed hopes, for the person he could have been.We grieve for your grief. Somehow through that grief, I learned to celebrate new life. (Your baby) taught me something medical school never could. He taught me how to love my patients and then he taught me how to let them go. He taught me that the lessons of medicine don’t end with death, and he reminds me every day to be more empathetic, more compassionate, and more forgiving, because sometimes all we have in this life is just a few precious breaths and then we’re gone.’ It is a challenge to maintain the empathy and compassion that this doctor so clearly manifests throughout our training and working lives, and it is bold and enlightened of her to state ‘I want you to know that your doctors do grieve’. Unfortunately the impression often given either implicitly or perhaps explicitly during our training is that emotional involvement with patients is wrong and unprofessional, so if not careful we can gradually become cut off from our emotions and unable to relate to them in a straight forwardly humane way. This is not good for our patients or for ourselves, and pushes us along the road towards burnout. Of course we need sufficient ‘professional distance’ to function competently as their medical practitioner, but that does not require that we have no emotional involvement with them at all. There are an increasing number of studies showing that empathy and compassion expressed by health-care professionals improve patient outcomes. Jesus Himself famously wept at the death of Lazarus2, and probably on other occasions not recorded in scripture. People from all faiths and none can agree that He was the perfect physician, so seeking to follow His example encourages us to allow ourselves to feel the pain of grief and loss as we empathise with our patients. We’ll soon be celebrating Christmas, reminding ourselves again of the mystery of the Incarnation. God became a human baby to enter into and experience the pain, anguish and sorrow of all that it

means to be a human being. His ultimately therapeutic life (and death) is the supreme example of how grief (of God for lost humanity) can be a catalyst for new life-enhancing possibilities. So allow yourself to grieve for your patients and their losses, and don’t be afraid to teach your students that it is appropriate to do so. There are many things we can learn from encountering our patients’ lives that medical school will never teach us. References: 1. The_Night_Your_Child_Died___An_Open_Letter_From.24.aspx Sarah Mongiello Bernstein © 2016 by the Association of American Medical Colleges 2. John 11, 35

Huw Morgan 11/16

Lessons learnt  
Lessons learnt  

"There are an increasing number of studies showing that empathy and compassion expressed by health-care professionals improve patient outcom...