Self-care is to grieve properly

In Palliative Care we lose treasured patients. 

Patients who have had an impact on our lives, touched our hearts and those who we’ve connected with on a far deeper level than others.

We lose patients who have made us laugh heartily and those that forced us to sit down for a prepared lunch and a sneaky drink at 11 am on a home visit. We lose patients who’ve shared their wisdom and experience in their last days and for me, it’s those patients who’ve made me think and reflect on my own life.

Our hearts may ache and we may shed a tear too when we learn about their death. We may instantly miss their presence, their energy and the way that they used to make us feel.

This is grief.

Grief is loss. The death of anything sacred and significant in our world. 
 
But have you ever given a thought as to how we move on? 

And,

What do we do with the grief that we are experiencing? 

Where does our grief go? 

We intuitively know that isn’t beneficial to stash our grief away, pushing it aside, deep into our subconscious to deal with later or to divert our attention and “move on to the next”.
 
See, grief that isn’t dealt with appropriately can start to impact our mental and physical wellbeing and can be a precursor to burnout. The impact of grief on our spirits too can leave us empty and disconnected from the things we love and that replenish us with energy — the central purpose of intentional self-care.

“Grief that turns into burnout is grief with no place to go”
 — Dr Naomi Remen (Kitchen Table Wisdom)

In her wonderful book Kitchen Table Wisdom, Dr Remen says that grief is a process that must occur to transfer love from what we’ve lost and find the meaning of what has occurred. Grief is a process that must take place for us to heal and to move forward as whole beings. If we simply “move on to the next,” we risk burning out and feeling empty as our grief is unresolved. 

Our grief must be dealt with. 

Our grief must find somewhere to go.

As Palliative Care professionals we swim each day in a sea of suffering and to think that we aren’t touched or “get wet” by this, is ludicrous.

Dr David Kessler defined grief brilliantly as, “the death or loss of something/anything significant in our world”. Looking widely, grief can be the death of a loved one, a divorce or relationship breakdown, a job loss, a significant medical setback and for us working in Palliative Care, the death of our patients.

 Can I encourage you that it is okay not to be okay? We do not need to have it together all the time. All of us can be affected when we least expect it — not one of us is immune to grief.

But we must find an appropriate and healthy place for our grief to go.

My grief and self-care

My grief finds its way into pages — into my prayer journal, my morning pages and the articles that I write. Key-strokes and pen strokes, the words that I write matter to me and they matter to others too. Because without them, I know that I would drown in an abyss of sadness and my gift to the world would cease to give anymore.

Running helps me too. Unscrambling the jumble of thoughts in my head as my feet hit the pavement or trail. A stream of clear cathartic consciousness made possible by finding silence, solitude and sometimes tears.

Not long ago we lost a patient. She wasn’t even a year old. My grief found its way into this piece and others as I reflected on her life. I write to find meaning and I write to celebrate those who’ve touched my heart and whose spirit met mine. The weekend after she died, I ran and I wrote, with tears into my journal. I spent time with my boys and at night I reclined in Kylie’s arms. And in the silence and solitude of prayer one morning I saw promise, the gift of a new day and a chance to make a difference again. I’ll always remember you little one, thank you for letting me take care of you, you are loved eternally by your parents and your Father in heaven.

 To grieve properly is to care for yourself. 

To grieve appropriately is central to self-care. A professional requirement of those who choose to swim in a sea of suffering each day.
 
Tears. Words. The embrace of another. Silence and solitude. Talking. Mindfulness. Writing. Therapy. Professional supervision. Nature. Church. Temple. Prayer. Meditation. Art— these are examples of self-care in grief.
 
My encouragement to you is to acknowledge that grief is part of working in Palliative Care and Medicine and to find a unique place of rest for your grief. A place of replenishment and healing. A place that is meaningful which restores joy to your soul and vitality to your work. An appropriate transfer of love.

Without ever feeling the bottom, how can we ever experience the heights of love, pleasure and joy? 

You are a gift and we need you.

Thank you.
 

Live and care for yourself intentionally.

Love relentlessly and open your heart.

Enjoy your health, it is everything.

Dr. Jonathan Ramachenderan 
@thehealthygp