In interviews with 20 oncologists addressing the nature and impact of grief related to the loss of a patient, the single most consistent and recurrent finding was the description of the concept of compartmentalization. The participants described their ability to separate feelings of grief from other aspects of their jobs and lives after the death of a patient, characterizing it as a coping strategy and a result of continual patient loss.
The study by Leeat Granek, PhD, of the Hospital for Sick Children in Toronto, Ontario, Canada, and colleagues also revealed that oncologists employed the strategy of distancing themselves from a patient and the patient’s family as death drew closer by making fewer hospital and bedside visits and by expending less energy overall on the patient.
The oncologists, who were interviewed in three groups, were men and women from three different adult oncology centers in Ontario. They represented different subspecialties, ethnicities, and career stages.
As the investigators described in a research letter published in Archives of Internal Medicine (2012;172:964-966), the grief experienced by the interviewees had unique elements beyond sadness, crying, and sleep loss. These elements related to the providers’ sense of responsibility for their patients’ lives, and included feelings of powerlessness, self-doubt, guilt, and failure.
Most of the participants reported feeling that they could not strike the proper balance between growing close enough to care about a patient while remaining distant enough to avoid feeling pain when the patient died. The oncologists discussed having difficulty separating their work lives from their personal lives by bringing their grief home with them, but many also talked about having a better perspective on life as a result of frequent exposure to patient loss. ONA