Grief on Our Side

In the movie, The Lion King, meerkat Timon and warthog Pumba meet lion cub Simba who is weak, lost and alone. As potential meals for lions, they are understandably anxious about being up close and personal to a lion, even such a small one in a bad way. In the end, however, they decide to befriend Simba thinking that life would be different with a lion "on our side."

For most of life, it makes a difference whether someone is "on our side" or on the "other side" of a situation. For those of us who work in healthcare, we experience this difference when someone we know—not a patient—has a healthcare crisis. Most folks consider the death of a family member to be one of the most, if not the most, difficult losses that anyone can experience. But this is the kind of experience that many of us in healthcare have experienced many times, sometimes several times in a month, a week or even a day. These are intense and extreme experiences for which most of the world—and our world outside healthcare—are unfamiliar, yet they are not unfamiliar for us. While we work to not become cold or indifferent, in order to walk the halls we walk and enter the rooms with families and patients to which we are called, we have to become accustomed to the territory. In a limited sense, we adjust—we get used to it to some degree. This adjustment is necessary and adaptive if we are to work for an extended time with patients who suffer and sometimes die and with their families. They need us to adjust and have less anxiety than a typical person would normally experience in these abnormal circumstances.

Our adaption to the kinds of loss we see in our daily work can lead to some strange realities. The death of a family's only child with whom we worked and cared can have less impact on us than the death of our aged grandparent whose dying is anticipated and perhaps even relieving. How can this be? The death, injury or illness of a family members, friend or coworker is different as they are "on our side." Losses in our personal world slip past our professional defenses, and so they are particularly upsetting and threatening. When we work in a hospital, we expect that our patients will be sick or hurt, and depending on our area, we may also expect that some of our patients will be overcome by their illnesses or injuries and die. We don't want this, we work hard to prevent it, but realistically we know that not all deaths can be prevented. We signed on for this, and if we're still coming to work, part of us knows that this is a sad and real part of the package deal that we applied for and accepted.

What we didn't apply for and have greater difficulty accepting is when the threats to health hit close to home, and "home" can be our coworkers and friends as well as those who actually live in and visit our literal homes. We know that sometimes homes get broken into and robbed, but when it happens to us, it is distressing and frightening in a different personal way.

The threats that happen "on our side" can come in many forms. Sometimes it's when our family member is sick or injured. It can be the death of someone we love outside of our professional responsibilities of caring for others. It can also be when friends, coworkers or their families are struck with a serious illness, accident or death.

There are losses for which we prepare in our work in order to cope. Years ago, I became aware that when I met a child with a new cancer diagnosis, I would unconsciously think to myself, "This child may die while I know him or her." In the big picture, this is true about anyone we meet, but it was a helpful coping strategy for knowing and caring for the children who eventually did die. All of us need strategies to help us live in healthy ways with the suffering and loss we encounter in our work. And we need strategies that help us cope when the suffering and loss occurs with family, friends and coworkers, whether it's feels like a sneak attack through our defenses or a bomb lobbed over the wall. Either way, despite the heavy kinds of work we do, we can feel particularly exposed and vulnerable when losses land on our side.

Greg Adams