Management of grief and loss: medicine's obligation and challenge

One of medicine's least taught and acknowledged areas is the physicians' obligation to the surviving families of patients who have died under our care. The uncomfortable feelings engendered by the death of a patient often lead to ending contact with the family of the deceased. However, this response fails to recognize the importance of the role that the treating physician continues to have for the surviving family. A phone call, letter, or attendance at the funeral has enormous meaning and value for the family. This role also provides the doctor with an opportunity to deal with the "minigrief" reaction that follows the death of a special patient, and it reduces the adverse effects of unacknowledged, cumulative losses that lead to burnout. Although the deaths of patients and our efforts to help their grieving relatives may be the "dark" side of medicine, this side can be among the most rewarding when it helps bereaved loved ones and ourselves to survive loss.