Skip to content
  • About
  • Contact
  • Contribute
  • What Physicians Say
  • My Book
  • Careers
  • Podcast
  • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
KevinMD.com — Social media's leading physician voice
  • All
  • Physician
  • Burnout
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
    • All
    • Physician
    • Burnout
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • About
    • Contact
    • Contribute
    • What Physicians Say
    • My Book
    • Careers
    • Podcast
    • Speaking
  • About Kevin Pho, MD, Founder of KevinMD
  • Aging and dementia: what physicians say, in their own words
  • Artificial intelligence: what physicians say, in their own words
  • Be heard on social media’s leading physician voice
  • Cancer: what physicians say, in their own words
  • Children’s health: what pediatricians say, in their own words
  • Contact Kevin
  • COVID-19: what physicians wrote as it happened
  • Custom enhanced author page pricing
  • Diabetes and obesity: what physicians say, in their own words
  • Direct primary care: what physicians say, in their own words
  • DMCA Policy
  • End of life: what physicians say, in their own words
  • Establishing, Managing, and Protecting Your Online Reputation: A Social Media Guide for Physicians and Medical Practices
  • GLP-1 drugs: what physicians say about Ozempic and its successors, in their own words
  • Heart disease: what physicians say, in their own words
  • Immigration and medicine: what physicians say about immigrant doctors and immigrant patients, in their own words
  • KevinMD influencer opportunities
  • Medical errors: what physicians say, in their own words
  • Medical ethics: what physicians say, in their own words
  • Medical malpractice: what physicians say, in their own words
  • Medical school: what students and physicians say, in their own words
  • Mental health: what psychiatrists and physicians say, in their own words
  • Nursing: what nurses and physicians say, in their own words
  • Opinion and commentary by KevinMD
  • Opioids: what physicians and pain patients say, in their own words
  • Physician burnout speakers to keynote your conference
  • Physician burnout: what physicians say, in their own words
  • Physician Coaching by KevinMD
  • Physician keynote speaker: Kevin Pho, MD
  • Physician personal finance: what physicians say about their own money, in their own words
  • Physician Speaking by KevinMD: a boutique speakers bureau
  • Physician suicide: what physicians say, in their own words
  • Physicians and administrators: what physicians say about who runs medicine, in their own words
  • Primary care physician in Nashua, NH | Kevin Pho, MD
  • Primary care: what physicians say, in their own words
  • Prior authorization: what physicians say, in their own words
  • Privacy Policy
  • Private equity and corporate medicine: what physicians say, in their own words
  • Race and medicine: what physicians say, in their own words
  • Recommended services by KevinMD
  • Residency: what residents and attendings say, in their own words
  • Scope of practice: what physicians, nurse practitioners, and PAs say, in their own words
  • Subscribe to the KevinMD enhanced author page
  • Subscribe to the newsletter
  • Surgeons and surgery: what surgeons say, in their own words
  • Take-home messages: what physicians say when asked to leave one
  • Terms of Use Agreement
  • Thank you for subscribing to KevinMD
  • Thank you for upgrading to the KevinMD enhanced author page
  • The electronic health record: what physicians say, in their own words
  • Vaccines: what physicians say, in their own words
  • Violence against health care workers: what physicians and nurses say, in their own words
  • What physicians say: the KevinMD records
  • Women in medicine: what women physicians say, in their own words
  • Women’s health: what physicians say, in their own words

How this physician does her job while grieving

Dr. Caroline Macari
Physician
May 23, 2019
Share
Tweet
Share

Two years ago, something happened that — not to be overly dramatic — changed my life, including my everyday experience of my job as an emergency specialist.

My older brother, Martin died of a rare and aggressive form of non-Hodgkin’s lymphoma that spread despite every treatment that was thrown at it.

When he was dying, I managed to unleash in myself a raging anxiety, which caught me by surprise. In the year after his death, I was forced to look at everything about my life — my work, my loves, my practices — to figure out how I could not only cope, but thrive.

I know many of you have been through the same thing. I would notice your names crossed off the roster. And then there you would appear, back on shift a couple of days later. Not a word would be said. When it was my turn, I wondered how everyone else had done so well, whilst there I was crying all the way to work every day in my car. But I guess the reality is: you probably weren’t doing OK — we just didn’t ever talk about it.

I want to share just a few of the lessons I learned about my experience of doing our job while living through personal grief. There is no shame in struggling to do our job when we are raw and in pain. I would love to start a conversation where we are allowed to admit this.

Have compassion for yourself so you can have compassion for others.

It is very hard to care with grief in your heart. As doctors, it is our job to care. We need to show compassion to those we treat, even though we may think their complaint is ridiculous. To them, this is their worst day, and they have come to us to seek reassurance.

One evening shift I received a phone call from my mother, distraught that my brother was on three infusions of drugs that were “keeping him comfortable” and she was begging for them to treat him, not just drug him. We felt his death was imminent, but it still seemed premature. After this extremely upsetting phone call, I sat alone and cried. I then walked downstairs to immediately be reemerged into a world where my juniors were lining up to ask for advice about their patients with sore throats, a stubbed toe or a rash they’d had for a week.

It is extremely hard to care, to show compassion when your heart is at the full-to-bursting point with fear and sorrow. However, as a doctor, especially one in charge of a department, we just get through it. We lock off the pain and keep going. But this is not fair to our patients. You must look after yourself. Take time off if you need it. Your department will survive without you, no matter what you think.

You cannot work our job when you can’t care at all.

Don’t be afraid to talk about grief.

I would love to talk about my brother more than I do. There is nothing like ending a story with “but he’s dead now” to bring an abrupt and overwhelmingly awkward end to a conversation. The pity face comes, and then the “I’m sorrys” will follow. And then that is the end of that. No more questions.

My brother may be dead, but I still have a relationship with him. He is still my brother. He is still part of my life. More and more, it feels like this part of my life never gets spoken of. More and more it feels as if he is truly gone.

ADVERTISEMENT

It is a common feeling in those grieving that they can’t find anyone that will listen. No one will bring up their loved one’s name for fear of upsetting them. Don’t feel like you have to say anything useful — just listen. A simple “tell me about your grief” or asking them to tell you something about their loved one is all that is needed. It helps to bring their loss into the open and make a seemingly impossible event feel real.

If the grief or loss is carried by a patient, taking this approach helps our patients to feel like we care about them as a human, and helps to keep their loved one alive.

It’s OK to cry.

I don’t know at which point in our career we become completely hardened to what we see. It’s not like we get taught to be emotionless — it is just a learned survival skill. We simply don’t think about the vicarious trauma we see every day and tend to have a “Next!” policy. But when you stop to think about this, isn’t it unbelievable that we can do this?

Shortly after my brother died, I experienced the humiliation of publically crying after my second resuscitation of the day ended in an unavoidable patient death. I was treated like I was broken and escorted by worried staff off the floor. I was mortified. I saw myself as weak and an embarrassment.

I told this story to someone external to medicine. Their response inspired me: “I am so glad you cried, it makes you a human being. If you could see what you see every day and not be affected, then I would worry you are a psychopath.”

Palliative does not mean do nothing.

As soon as we see the word “palliative” in a patient triage, we immediately downgrade our concerns and go into “comfort mode.” Palliative to me now means I know their destination, but they still have a journey before they get there. They still have life, and they still have hope.

My brother was palliative and living in a hospice for five months. In fact, it got a bit awkward. We used to joke he would have to start paying rent soon.

But in these five months, he got to see the new “Star Wars” film with his son. He got to have one more Christmas with his children. He even managed to sell the rights of a book he had written to a television production company. He may have been labeled “palliative,” but he continued to live a fulfilling life. Multiple times he was almost sedated to death and “kept comfortable” for completely reversible causes.

We watched in horror, for example, as he was increasingly sedated and given analgesia for constipation without bothering to treat the cause. I’m not suggesting heroics in our management, but perhaps pause to ask what the patient and family want in this moment. For many, pain relief is what they want; for others, it’s just a reversible bump in their path and today is not their time.

Eventually, my brother was ready. He told everyone he was done. In the end, he was hoping for death and faced it with the grace and bravery he did his entire illness.

Caroline Macari is an emergency medicine physician in Australia.

Image credit: Shutterstock.com

Prev

How PTSD is hurting nursing

May 22, 2019 Kevin 6
…
Next

How a disability changed this medical student

May 23, 2019 Kevin 2
…

Tagged as: Emergency Medicine, Oncology and Hematology

< Previous Post
How PTSD is hurting nursing
Next Post >
How a disability changed this medical student

 

ADVERTISEMENT

More by Dr. Caroline Macari

  • Grief on the front line

    Dr. Caroline Macari

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD
  • Embrace the teamwork involved in becoming a physician

    Nathaniel Fleming

More in Physician

  • 3 reforms to counter wellness influencers in practice

    Farid Sabet-Sharghi, MD
  • Choosing a limb lengthening surgeon requires accountability

    Hrayr Basmajian, MD
  • How to reassure patients: 5 steps beyond normal tests

    Devina Maya Wadhwa, MD
  • Setting boundaries as a physician doesn’t mean caring less

    Jerina Gani, MD, MPH
  • How emergency medicine decision making works under pressure

    Geoffrey Mount Varner, MD, MPH
  • Why I stay in emergency medicine: a dancer at nearly 100

    Howie Mell, MD, MPH
  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • The conflict of interest that discloses as nothing

      Martha Rosenberg | Medications
    • Surgical judgment: the skill no one sees from the gallery

      Mustafa Kemal Çalık, MD | Physician
    • Why haven’t ambient AI scribes boosted productivity?

      Karan Kanwar | Health Technology
    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Physician well-being is not an individual problem

      Heather Buckley | Conditions and Diseases
  • Past 6 Months

    • Why CDC opioid guidelines get the overdose data wrong

      Richard A. Lawhern, PhD | Conditions and Diseases
    • Retirement isn’t the end of medicine, it’s a second act [PODCAST]

      The Podcast by KevinMD | Podcast
    • Sensory processing in autism and the brain’s volume control

      Josette Pelatan, PhD | Conditions and Diseases
    • What maternity care deserts cost a town

      Manisha Kaliaperumal | Health Policy
    • Why medicine needs a national physician license now

      Vaishali Popat, MD, MPH | Physician
    • A cold cost $945. The cost of primary care is broken.

      Susan Newman, MD | Physician
  • Recent Posts

    • 3 reforms to counter wellness influencers in practice

      Farid Sabet-Sharghi, MD | Physician
    • Shift work and circadian rhythms shape the 24/7 workplace

      Deepak Gupta, MD | Conditions and Diseases
    • Paid for twice

      Physicians paid for G2211 twice. Most never bill it.

      Michael Duben, MD | Physician Finance
    • The next child

      Medicaid managed care and the case for mutual stewardship

      Steven Merahn, MD | Health Policy
    • Choosing a limb lengthening surgeon requires accountability

      Hrayr Basmajian, MD | Physician
    • Cited but never checked

      Why AI crisis advice may fail families facing psychosis

      Nicole Drapeau Gillen | Health Technology

Copyright © 2026 KevinMD.com | Powered by Astra WordPress Theme

  • Terms of Use Agreement
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...