I have contemplated this post for over 2 months. My grief is new and strange. It ebbs and flows, comes and goes but never totally leaves me. I don't think it ever will. I can't seem to write anything that can describe, what I have felt or what I don't know how to feel? Years of work with a human being, the sense of being caught off guard, the recognition of the ultimate risk and the realization of my limits; the loss is immense and deeply personal.
I had plans of "As long as it takes." I had to delete the recurring appointment from my calendar. The act of ultimate acceptance of what had happened, accepting another human being's decision to handle their pain in a way, we were working to avert and accepting that one of us had a different timeline for "as long as it take." I have struggled with continuing to do therapy work, at least at this time. The wound is deep and it doesn't look like it's filling anytime soon because it's so entwined with what I do every day. We all operate on a certain ambivalence towards our patient's wishes of annihilation, as it helps us circumvent the risk staring at us everyday, and helps us choose hope for our patients. Those of us who have lost patients, lose the comfort of hope for a while.
I recently came across a profound comment by a fellow psychiatrist, on a post I was following. "There are two kinds of psychiatrists. Those who have lost a patient to suicide, and those who will." Though I usually don't look at things in such black and white, but this deserved attention.
The patient suicide, in psychiatry is the ultimate heartbreak club. A not so sought after club, with a high priced membership and only an entry door. There are no exits, no detours, and no one is excused. At some point, anyone of us can become members, and find ourselves on the other side of the door.
Meg Murry describes the pain of tessering, when she found herself traversing dimensions of our universe, looking for her father, in "A Wrinkle in Time." The journey through the door of the heartbreak club for a psychiatrist, may as well be tessering to a different dimension. Nothing prepares you for this. Sure, we have all read about patient suicides, heard other psychiatrists, therapist and clinicians, talk about their experiences. But it doesn't become visceral, until it's your own patient.
We have different kinds of relationships with our patients, when we see patients for the afflictions of mind and try to help them the best we can. Some of us are lucky enough to practice psychotherapy along with medication management. The therapy relationships are different from medication management. One isn't better than the other, but one is more intense and pulls on the heart strings more.
When we decide to become physicians and take care of patients, we assume the risk of having heartache and hurt. As psychiatrists at one point we find out that with the best of our intentions, care and investment in our patients, sometime we can't prevent the final outcome. Our knowledge of another human being is limited to only, what they present to us, nothing more, nothing less.
I will just have to wait for the heart to mend itself and get back to doing the work that I love so much.
As the saying goes,
“To practice medicine with good spirit does not mean to be in a place where there is no noise, trouble or hard work. It means to bring your calm and loving heart right into the midst of it.”
Unknown Author
I had plans of "As long as it takes." I had to delete the recurring appointment from my calendar. The act of ultimate acceptance of what had happened, accepting another human being's decision to handle their pain in a way, we were working to avert and accepting that one of us had a different timeline for "as long as it take." I have struggled with continuing to do therapy work, at least at this time. The wound is deep and it doesn't look like it's filling anytime soon because it's so entwined with what I do every day. We all operate on a certain ambivalence towards our patient's wishes of annihilation, as it helps us circumvent the risk staring at us everyday, and helps us choose hope for our patients. Those of us who have lost patients, lose the comfort of hope for a while.
I recently came across a profound comment by a fellow psychiatrist, on a post I was following. "There are two kinds of psychiatrists. Those who have lost a patient to suicide, and those who will." Though I usually don't look at things in such black and white, but this deserved attention.
The patient suicide, in psychiatry is the ultimate heartbreak club. A not so sought after club, with a high priced membership and only an entry door. There are no exits, no detours, and no one is excused. At some point, anyone of us can become members, and find ourselves on the other side of the door.
Meg Murry describes the pain of tessering, when she found herself traversing dimensions of our universe, looking for her father, in "A Wrinkle in Time." The journey through the door of the heartbreak club for a psychiatrist, may as well be tessering to a different dimension. Nothing prepares you for this. Sure, we have all read about patient suicides, heard other psychiatrists, therapist and clinicians, talk about their experiences. But it doesn't become visceral, until it's your own patient.
We have different kinds of relationships with our patients, when we see patients for the afflictions of mind and try to help them the best we can. Some of us are lucky enough to practice psychotherapy along with medication management. The therapy relationships are different from medication management. One isn't better than the other, but one is more intense and pulls on the heart strings more.
When we decide to become physicians and take care of patients, we assume the risk of having heartache and hurt. As psychiatrists at one point we find out that with the best of our intentions, care and investment in our patients, sometime we can't prevent the final outcome. Our knowledge of another human being is limited to only, what they present to us, nothing more, nothing less.
I will just have to wait for the heart to mend itself and get back to doing the work that I love so much.
As the saying goes,
“To practice medicine with good spirit does not mean to be in a place where there is no noise, trouble or hard work. It means to bring your calm and loving heart right into the midst of it.”
Unknown Author
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