Thread by @chungk1031

Dealing with dying patients.

#MedTwitter

A 🧵

I was prepping for a panel discussion with medical students on death and dying. Had to get some thoughts together based on my experience as a military intensivist so I thought I would share.

I’ve experienced my share of death. Of course the typical “taking terminal patients through the dying process” kind of stuff that every internist and intensivist deals with…

But also lots of untimely deaths that I have had to process during my time in the burn unit and my deployments to combat support hospitals in Iraq in Afghanistan. Stretches of deaths back to back to back to back. Many of them young. Those times were ROUGH. No lie.

In this regard, what I am seeing everyone experiencing now with the #COVID19 pandemic is very similar.

My first thought is that empathy and compassion are finite. No matter how ‘full’ your emotional tank may be.

You. Will. Run. Out.

It did for me. Many times. I remember on more than one occasion deferring the “your loved one is dying” talk with family. And skipping the ‘angle flight’ ceremony or patient memorial just because I couldn’t.

Sometimes there is too much death to process. We are human. What’s important is for you to recognize when you are empty and let your team know. You also have to recognize this in others and cover for them if you have the capacity on that day.

I have found on occasion that I need to dissociate myself mentally from what’s going on so that I can push through and do what needs to be done. Especially when there are too many deaths.

But at some point later on, I know I have to give myself some time to process what happened and maybe talk to someone about it. Like an informal debrief. I’ve found it is helpful to do this with the same people you were in the trenches with.

Next, acknowledge that in some situations, life is worse than death. Especially when someone is suffering. Helping families navigate through the dying process is part of your job. Knowing your patient died peacefully and with minimal suffering can be rewarding.

Finally, take care of yourselves and take mental breaks when you are able. Take care of each other. Your future patients and families are counting on you.

#Selfcare
#Wellbeing
#InThisTogether

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Thanks @FMCiminoMD and @DrGossa for inspiring this thread!

@USUhealthsci