A Sad Story

I love ob/gyn. I love the mommies, I love the daddies, I love talking to them throughout the pregnancy. I love deliveries and c-sections. I love the older women, talking to them about menopause, osteoporosis, and healthy aging. I even like gyne surgery and pap smears, things I never thought I would enjoy. Most of all, I love feeling like I can make an uncertain or uncomfortable time a little more understandable and comfortable for a woman. Ob/gyn is great. The highs are high...a healthy delivery, a healthy mommy. The lows are low.

Today I saw two babies die. One was a second trimester miscarriage, one was an IUGR with not enough lung maturity to survive. In both cases, it startled me because it was supposed to be a normal pregnancy. Only when I saw the mother's water break in her 15th week and only when I opened the uterus did something seem wrong. The 15 week old baby was perfect, 6 inches long, with facial features and tiny fingernails. I don't know why it was born too early. What I do know is that it was my responsibility to help the mom deliver safely and to support her, and communicate to her that this was not her fault. It struck me as a tremendous burden on the physician, to both medically and emotionally care for the patient while experiencing their own shock and grief over the situation.

One way to survive is to distance yourself from the patient and the situation. This to an extent is the calling of the doctor, so he can provide the best care possible. I feel like I am good at this. But I also feel like it is not in my nature to become a doctor who is aloof and distant from patients' needs and pain. One of the main reasons that compelled me to go to medical school was that I care about people.

So my question is this: how does a doctor deal with his or her own sadness over a patient's situation? I suppose in the end it is a mark of a doctor who cares deeply about his patients, and that is the kind of doctor a patient needs.