How naming grief can restore meaning in medical practice

Almost every day, a physician says to me some version of the same sentence.

It may sound like frustration about metrics. Or exhaustion. Or administrative opacity. But beneath it is something more elemental:

“I am grieving what I hoped medicine would be.”

When that sentence is spoken plainly, without defensiveness, something shifts.

The suffering moves from defect to meaning.

Grief, in existential thought, is not weakness. It is evidence of attachment. We grieve what we loved, what we invested in, what we believed would endure. When a doctor grieves medicine, they are not merely objecting to workload or policy. They are mourning an internal covenant. The imagined future in which medicine would remain a calling rather than a commodity. The future in which technical mastery and moral purpose would reinforce one another. The future in which competence and humanity would not feel in tension.

To name this grief restores coherence

Unspoken, the distress often appears as irritability, detachment, cynicism, or what the literature describes as burnout or moral injury. Those terms capture important dimensions of physician distress. But they do not always reach the core.

Beneath the surface lies a collision between expectation and reality.

Early in training, a physician constructs a narrative about who they are becoming. That narrative organizes sacrifice, debt, geography, relationships, even identity itself. It carries the promise that the work will justify the cost. When the lived system no longer resembles that imagined horizon, something destabilizes. Not because the doctor is fragile, but because the organizing story has fractured.

Viktor Frankl observed that despair emerges when suffering loses meaning. By this he meant that difficulty alone is tolerable. Difficulty without coherence is not. A physician working long hours for a cause they believe in may feel exhausted yet aligned. The same hours under conditions that feel transactional and misaligned may produce emptiness.

Naming grief reintroduces meaning

It also separates identity from institution. When a doctor says, “I am grieving what I hoped medicine would be,” they are no longer saying, “I am broken.” They are saying, “Something I valued has changed.” The linguistic difference is small. The psychological difference is substantial. The first invites shame. The second invites reflection.

There is also an ethical dimension. Many physicians entered medicine with a moral aspiration: to alleviate suffering, to belong to a profession guided by shared standards, to practice within a community of trust. When commercial pressures, algorithmic metrics, or opaque administrative mandates disrupt that moral continuity, the distress is not merely emotional. It is ethical disorientation. The grief reflects a loss of alignment between values and daily action.

And grief, once acknowledged, can be integrated.

Mourning does not mean returning to an earlier era. It means incorporating loss into a revised self-understanding. The physician who recognizes that medicine no longer matches their original ideal is freed from the exhausting effort of forcing reality back into alignment with that ideal. Energy previously spent in resistance can be redirected toward adaptation.

This is not resignation. It is clarity.

Clarity allows different questions to surface. If medicine is not what I imagined, what remains worth preserving? What aspects of my vocation are portable across systems? What does integrity look like under present conditions? These questions reposition the physician from passive casualty of systemic change to active interpreter of it.

Maturity, in this sense, involves tolerating ambiguity without collapsing into cynicism. Institutions evolve, sometimes regress. Identity must be more durable than structure. A doctor who can grieve openly is less likely to fuse self-worth entirely to professional context. They can hold disappointment and commitment simultaneously.

There is hope embedded here. Not optimism about the system. Agency about the self.

Once the loss is acknowledged, response becomes possible. Some recalibrate their practice style. Some advocate for reform. Some narrow focus to what they can influence. Some leave clinical medicine but retain the healer’s identity in new forms.

The shift is subtle but decisive.

Despair says: This is meaningless, therefore I am diminished.

Grief says: This mattered to me, and its alteration hurts.

One erodes identity. The other preserves it.

When the grief is spoken aloud, especially among peers who understand the culture of medicine, isolation decreases. The distress becomes contextual rather than personal failure. It belongs to a story.

And when suffering belongs to a story, it can be revised.

Not cured. Not erased.

But carried differently.

After decades in medicine, and years listening to physicians describe their private disappointments, I have come to believe this: When a doctor can name their grief clearly, without self-condemnation, they are already less adrift than they imagine.

And sometimes that recognition is enough to continue.

Patrick Hudson is a retired plastic and hand surgeon, former psychotherapist, and author. Trained at Westminster Hospital Medical School in London, he practiced for decades in both the U.K. and the U.S. before shifting his focus from surgical procedures to emotional repair—supporting physicians in navigating the hidden costs of their work and the quiet ways medicine reshapes identity. Patrick is board-certified in both surgery and coaching, a Fellow of the American College of Surgeons and the National Anger Management Association, and holds advanced degrees in counseling, liberal arts, and health care ethics.

Through his national coaching practice, CoachingforPhysicians.com, which he founded, Patrick provides 1:1 coaching and physician leadership training for doctors navigating complex personal and professional landscapes. He works with clinicians seeking clarity, renewal, and deeper connection in their professional lives. His focus includes leadership development and emotional intelligence for physicians who often find themselves in leadership roles they never planned for.

Patrick is the author of the Coaching for Physicians series, including:

He also writes under CFP Press, a small imprint he founded for reflective writing in medicine. To view his full catalog, visit his Amazon author page.