Abstract
E
As a physician in pediatric oncology and palliative medicine, I have spent years studying grief. Over time, I also have developed a profound respect for the importance of validating each individual's bereavement journey unconditionally, regardless of context or other unique particulars.
Yet despite my extensive medical training in bereavement, I stared blankly at my own grief for years. The shame of infertility cast a dark shadow across my life, reducing the months into endless cycles of hope and despair. As pregnancy dreams dissolved into disappointment again and again, I steeled myself to “get over it,” interring my grief without ever pausing to own it.
In retrospect, I did not feel entitled to grieve. I was selfish, I thought, to mourn children who existed only in my dreams. What right had I to wallow in sorrow when I compared myself with those families who watched their children die? To acknowledge my own sadness against the backdrop of their suffering felt borderline disrespectful; on a subliminal level, perhaps I feared that the lesser import of my grief might degrade the vast significance of theirs.
So when each of our embryos died, I hid in a hospital stairwell, blinking mechanically to dry my tears. Silently I berated myself; how could I justify creating space in my heart for my own sadness when it already overflowed with sorrow for my patients and their families?
Yet despite efforts to suppress my grief, it endured: it was a gnawing ache in my chest, a nausea that never abated. To survive in the world of palliative medicine, I learned to refocus my sorrow towards empathy. It was easier to get lost in the deep mazes of other people's grief: objectively, I took comfort in studying it, swallowing it up to drown out my own.
With empathy as my gold standard, I quietly camouflaged myself amidst the sorrow of others. Empathy was my job, after all, and also how I defined being a good doctor and person. Had I possessed enough self-awareness to hold a mirror up to my face, I would have seen the grief of others reflected back, and I would have mistaken it for evidence of my skill.
A few years ago I directed a hospital memorial service for bereaved families. Hours before the service I also underwent an urgent procedure to transfer a fragmenting embryo into my uterus. Racked by cramps, I stood at the podium and cried openly as I read aloud the names of the children who had died, fully aware that I was honoring their lives by mourning their deaths. At the time, it never occurred to me that I was denying this same respect to my own grief journey.
It took me years to find the courage to confront my own hypocrisy. The 19th-century writer Christian Bovee wrote, “Tearless grief bleeds inwardly.” In retrospect, I spent years hemorrhaging unspoken, invalidated sorrow until I shriveled into a shell of the person I had previously been.
Ironically, a colleague who is also a bereaved parent finally challenged me to face my grief. During an office visit she shared the story of her own infertility, the miracle of conceiving her son, and his subsequent death. I listened quietly, struggling to maintain composure. My intuitive colleague fixed me with a frank look and stubbornly insisted: Tell me your story.
The role reversal was humbling and disconcerting: as a fiercely private person, I had concealed my infertility from family and friends; as a physician who valued professionalism and boundaries, I had endeavored to exorcise personal problems from my work life; as a palliative care clinician, I was comfortable with listening to other people's grief, but uneasy at the prospect of sharing my own.
Yet as the words and tears tumbled out, I was surprised to feel a sense of peace gradually wrap around me. Although obvious in retrospect, I hadn't grasped the catharsis achievable simply by giving voice to repressed grief. For years I had told patients and families that grief is not absolute, but the right to experience it when it washes over you is an absolute right. With faltering steps, I began to acknowledge the importance of practicing what I preach.
I have learned that grief has many faces, all deserving of recognition and compassion. Caregivers, like patients and families, also have the right to experience sorrow. Our emotions do not detract from our professionalism; to the contrary, they are the crux of our humanity and integral to our role as healers.
When I hold up a mirror, I see my own grief reflected back now. It hurts immensely, but in acknowledging the pain, I validate my own journey and honor the lives of my patients along with the memories of those children whom I did not bear yet love all the same.