SGO Wellness: How I Stay Well When My Patients Aren’t—A Fellow’s Perspective on Wellness While Dealing with Grief
Martins Ayoola, MD
These past couple of months have been difficult. I’ve had goals-of-care discussions with some of my favorite patients about their progressive diseases and promptly recommended hospice for some. Nothing has been more challenging than watching patients my age pass away. Recently, I cared for a patient with progressive neuroendocrine cervical carcinoma who died at the age of 36. It has been emotionally exhausting and mentally draining, especially when it feels like all I’ve been delivering is uncomfortable news.
Grief is a terrible feeling to accept as providers. I’ve seen it expressed whether it’s crying with the family on rounds, just outside the door, or sadly, through annoyance. Every little thing irritates, and sometimes others bear the consequences of that. Sometimes it’s interwoven with guilt—did I do enough for this patient? Did I recommend hospice too late or too soon? Did I take away their hope? It’s a difficult emotion to process for me in our demanding profession. I’m busy with clinical and surgical obligations, administrative responsibilities, and preparing for what’s ahead. Soon the day is spent, and the next day, with its responsibilities, is on the horizon. I have been blessed to have the support of my attendings and co-fellows to help me process my feelings. I have colleagues who know it is important to acknowledge our emotions. We aren’t afraid to be vulnerable with one another, and it’s refreshing to hear their perspectives on these matters. I think gynecologic oncology draws empathic individuals to the profession such that we teach grieving by engaging in discussions and allowing for that space to be vulnerable with one another.
What has helped me? In tough moments, sometimes a song wells up in my heart and re-centers me. I can lose myself in the harmonies and tap to the beat. Although I might have heard the song many times before, there’s just something about the timeliness of the music and the rhythm that breaks me out of my funk. I keep humming the song, adding my own harmonies, and a smile stays on my face. In these moments, I’m reminded of my loved ones and it makes me appreciate my life. Other times, I’ll watch one of the many videos my wife sends me on Instagram and can laugh like it’s the funniest joke ever. With just a couple of minutes of comforting distractions, I feel rejuvenated and prepared to move forward. It’s my way of processing—a reminder of who is gone and the connection lost, but a joy that I have life and many things to be thankful for. I can still enjoy the people around me and add harmonies to the music of life. I have come to appreciate other activities that I never thought I’d enjoy. One newfound joy is engaging with my wife about her day while watching reality TV on Netflix. As silly as these shows can be, they bring me so much delight and entertainment. They create a world where, for a moment, I can forget about the difficult interactions I’ve had and just enjoy Garrett and Taylor’s journey to finding love. I even nerded out with them as they described their love for each other in thermodynamic terms. Cliché but true, laughter is great medicine. I have my set of YouTube videos that always make me laugh heartily. It doesn’t matter how many times I’ve watched them; they always provide the same euphoric feeling.
Finding time for wellness activities such as exercise is something that usually brings me great joy but can be a challenge. So, as I wrote this piece, I was determined to get back to one thing that brings me great joy. I stepped onto a basketball court, ran around for a bit, and put up some shots. In my mind, I still have skills and agility. I hyped myself up, thinking I’m just as good as these guys. Then my opponent said, “Hey, you look like my grandfather…” Great. Back to reality.
Martins Ayoola, MD, is a gynecologic oncology fellow at UCLA in Los Angeles, CA.