Grief hits us hardest when we least expect it.
I recently returned from the AAPA national conference in San Antonio, Texas, where I helped facilitate a small group discussion in the “Breaking Bad News” workshop. This ground-breaking seminar was the first of its kind sanctioned by the AAPA conference committee. Traditionally, continuing medical education national planners have considered such topics to be soft science, not worthy of recognition for ongoing educational credit.
The workshop was well-attended; over forty people showed up, and most stayed for the entire two and a half hour session.
We used Joan Didion’s book The Year of Magical Thinking as a literary text to facilitate discussion. In the pages of her journal, Didion records thoughts and feelings over the span of a year after her husband’s unexpected demise at the dinner table. Although outwardly she appears to have accepted the fact of his death, inwardly she continues to wait for his return during her year of magical thinking.
Immediately after the event takes place, the death of a loved one changes us forever in ways that we do not understand.
In small groups, participants had the opportunity to consider an instance when they were required to deliver bad news to a patient or receive bad news themselves. Without exception, the folks at our table found that they could readily recall such events with heightened clarity, although in most cases these events had taken place years ago.
Mourning, the process of working through grief, takes time. Sometimes, like a recurrent abscess, it requires periodic incision and drainage to heal.
I felt good about the discussions we had. I was amazed at how little time it takes for individuals to open up to complete strangers when given permission to do so in a safe place.
I returned home exhausted from my three-day trek. I never sleep well on the road. My son met me at the airport. We had a nice dinner together. It was only later after I checked my e-mail that I learned that a close friend’s family member had been brutally murdered by a street gang in another country while I was away.
Grief hits us hardest when we least expect it; mourning takes time.