What I learnt this week: Not revealing your grief doesn’t mean you are not hurting #WILTW

This is the 27th #WILTW

While it might be ‘trash’ I am quite a big fan of the American TV series ‘Arrow‘. It is pretty typical rich vigilante with very troubled past trying to right wrongs kind of stuff. A previous love interest of the hero died recently; an event which hit all of Arrow’s team (including their technology specialist Felicity Smoak) hard: 

Felicity: How can you stand there being so cold and rational?

Arrow (Oliver Queen):    ‘Cause I don’t have the luxury of falling to pieces. Everyone’s looking to me to handle things, to make the right decisions. Everyone is looking to me to lead.

If I grieve, nobody else gets to…

Felicity: You’re still a human being, Oliver. You’re allowed to have feelings. I know sometimes that it’s easier to live under that hood.

Arrow: I’m not.

(From Arrow Series 3 Episode 2 “ Sara“)

Comparing a TV series to Emergency Medicine may be one of my most dire conceptual leaps so far in #WILTW but there is a similarity between a team leader needing to stay in control during stressful and emotional resuscitations and Arrow’s dilemma. I am not promoting the emotionless doctor who remains un-empathic with a grieving family (in fact I have written previously on how I have been deeply moved by another consultant bearing all with a patient). I acknowledge though the team need someone they know will continue to function however upset/challenging they are findings things. Where does this strength come from?


The death of someone known to us inevitably highlights our own mortality. When that death is unexpected it can be very challenging, and the grief reaction can be powerful, regardless of how well you know the person. In making sense of acute loss I am reminded of the poignant words of a consultant colleague, Dr. Pro Mukerjee, speaking of that moment when you hear that someone has passed away.

At first there is a pause, a look of sadness and then almost always a smile as a powerful familiar memory of the good about that person surfaces

I find this reaction invariably true and I reflect that at times of deepest sadness there is some memory we can hang on to that which provides a modicum of positivity. Unfortunately in Emergency and Acute Care there is no connection with the person who has passed away. Although health care professionals deal with death regularly, so you might expect a certain amount of tolerance and resilience, the loss of the child or unexpected collapse of a person before their time is always upsetting. How do senior staff compose themselves to ensure both families and staff receive the time, compassion and information they need? I am not sure there is a universal method but certainly experience plays a significant role. What I am sure about is that the  reaction is still there, just placed somewhere else for a temporary period, so others can have the time they need.

What have you learnt this week? #WILTW

After writing this post I thought I would highlight Saying Goodbye. The Saying Goodbye Services are the first national set of remembrance services for people who have lost a child at any stage of pregnancy, at birth or in infancy, whether last week or 80-years ago. There is a very good video on children and grief by Dr. Ranj Singh on their website.

3 thoughts on “What I learnt this week: Not revealing your grief doesn’t mean you are not hurting #WILTW”

  1. It’s a funny thing grief… There is no right and wrong in how you do it and our own reactions are very much shaped by our personal experiences. I personally feel the fact I deal with death on a fairly regular basis at work means my own personal reaction to deaths of those I know and love is altered. This isn’t good or bad but it’s imperative I understand how I deal with death. I may not get upset at the ‘expected’ times but my feelings will creep out at others- through stress, or upset at a seemingly minimal issue. I know this, I am open about it when it happens. I am a sponge who can soak up so much before I start to ‘leak’.
    As I say there is no right or wrong way- what’s important is that you understand ‘your’ way, acknowledge your limits and have support networks in place.
    And bubble baths…. Lots of bubble baths 🙂
    Great work my friend.

  2. Nice post! It has surprised me how little I’m affected by the death of people in the ED. It is extremely rare that they die in the department, it is often a out of hospital cardiac arrest that can’t be resuscitated. But even when it has been a young person, I haven’t felt that grief in the resuscitation room. If everything has been managed well, that is, and there is no sense of responsibility. It all comes only if I meet the family.

    I remember a traffic accident where a 50 y old woman was killed. She came to the hospital in cardiac arrest. I think that’s how the EMS found her. A quick work-up assured me that there wasn’t anything more to do. I went to tell the family. They were calm and we started talking. Then the patient’s son answered his phone and said in a very upset voice: “My mother is dead!” It just hit me so hard and I felt the tears coming to my eyes. The dead patient became a person.

    Since then I have realized that what I experience is not so much related to the severity of the event or the outcome as based on the reactions of others, whether it is the patient or their families. A lost early pregnancy made me feel worse than a baby that died, when I was in Botswana, just because I felt the grief of the parents in the first case more vividly.

    Thanks for making us all think more about who we are and what we do.

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