Sadness and Grief: Episode 193
💙 Understanding Sadness & Grief in Medicine
Episode Overview
Part 2 of our emotional health series! Amanda, Laura, and Kendra continue the conversation about the harder feelings in medicine—this time focusing on sadness and grief. This isn't just about patient deaths; it's about the mounting, often invisible losses that accumulate over a career and silently fuel burnout.
🎯 Key Distinctions (Thanks, Brené Brown!)
Sadness ≠ Depression
Sadness is transient; depression is a cluster of symptoms over time
Depression can exist WITHOUT sadness (it's often just fog, fatigue, disconnection)
Sadness ≠ Grief
Sadness is ONE part of grief, but grief includes many emotions and experiences
Grief is not linear—it waxes and wanes, hits you when you least expect it
Positive Aspects of Sadness
Less judgmental errors, more empathy, greater generosity
Naming sadness is CRITICAL for compassion formation
Sad movies reconnect us with our humanity (and remind us emotions are temporary!)
💔 The 3 Elements of Grief
LOSS - Death, separation, identity, function, or things hard to describe
LONGING - Involuntary yearning for wholeness, understanding, meaning
FEELING LOST - Disorienting; requires reorienting your entire world
📋 Types of Grief in Medicine
Acute Grief: Tearfulness, insomnia, typically <1 year
Anticipatory Grief: Grieving before the loss (terminal diagnoses)
Complicated/Prolonged Grief: Intense, persistent, interferes with daily life
Ambiguous Grief: Loss without closure (hello, pandemic deaths we never processed!)
Disenfranchised Grief: Loss society doesn't acknowledge as legitimate
"Doctors, what do YOU have to be sad about? You've got it so good!"
Loss of autonomy, agency, the practice you thought you'd have
THIS is the sneaky one that intensifies burnout
🚨 How Grief Shows Up (And You Might Not Even Know It)
Emotional: Tearfulness, heaviness, numbness
Cognitive: "I could have done more," difficulty concentrating, rumination
Behavioral: Withdrawing from colleagues, reduced empathy, irritability
Physical: Fatigue, insomnia, appetite changes, unexplained aches
Clinical Spillover:
Overcompensating or avoiding complex cases
Declining call you used to handle fine
Emotional blunting during difficult conversations
Snapping at loved ones at home
📚 The Research That'll Make You Say "FINALLY!"
"Hidden in Plain Sight" Review (17 studies):
We're exposed to repeated death & bad outcomes with ZERO formal training
Healthcare workers feel unprepared because we have no bereavement training
Colleagues provide the MOST meaningful support (takes one to know one!)
What would help: paid time off after difficult cases, designated space to grieve, debriefing
JAMA Meta-Analysis (21,000+ physicians):
Depressive symptoms nearly DOUBLED the risk of medical errors
Mounting grief → emotional exhaustion → burnout → errors
We're setting ourselves up for disaster by not addressing this!
🌧️ The RAIN Method for Processing Emotions
R - RECOGNIZE: Name what you're experiencing
"I feel sad because this isn't what I wanted"
A - ALLOW: Accept it without judgment (just sit with it for 90 seconds!)
"I can sit with this sadness. I'm not gonna fix, avoid, or dismiss it"
I - INVESTIGATE: Get curious, not critical
"I wonder why this sadness is coming up? What am I believing?"
N - NURTURE: Self-compassion time!
What would you say to a colleague feeling this way? Say THAT to yourself
"It's okay to be sad. It's not your fault. You're not alone."
Why it works: Self-compassion activates your parasympathetic nervous system, decreases cortisol, improves sleep and wellbeing
🤝 The NURSE Framework (Helping Colleagues)
N - NAME/Mirror the emotion: "It sounds like you're feeling angry. I hear you."
U - UNDERSTAND: Seek to understand their feelings
R - RESPECT
S - SUPPORT
E - EXPLORE: "Tell me more" OR "Can I offer you a coach/therapist?"
💡 What We Can Do
For Ourselves:
Practice RAIN regularly
Journal after you understand it wasn't your fault
Go for walks (use your body to regulate big emotions)
Cry (it's an incredible release!)
Reach out for counseling (it's brave, not weak)
For Each Other:
Sit across the table: "Yeah, this is tough. I'm in this with you."
Group debriefs after difficult cases
Connection, connection, connection!
Meaning-Making:
Group coaching, rituals of closure, processing with those who GET IT
📖 Must-Read Resource
"Grief Healed: A Physician's Guide to Dealing With Grief and Thriving" by Dr. Shona Bhatnagar
Written by a full-time practicing physician who lost her husband unexpectedly AND her son to chronic illness in 10 months. Real, raw, doctor-to-doctor wisdom.
🎯 Your Challenge
Next time grief shows up, ask:
"What is this feeling telling me?"
"How can I connect with this experience and accept it?"
"How can I reach out from here?"
Remember: Isolation isn't the final answer. Community, compassion, and courage through connection—that's how we heal.
Need to talk? We're here. Email us at [email protected] or book a free session at www.thewholephysician.com
You are whole. You are a gift to medicine. The work you do matters. 💙
Sources:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12174799
https://www.aafp.org/pubs/fpm/issues/2023/0900/physician-grief
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2755851
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