Surviving bone marrow transplantation: the patient in the other bed

Patients hospitalized for bone marrow transplantation tend to deny the significance for them of the death of another transplant patient. Patients emphasize, often with encouragement from the medical staff, the differences between their conditions. Interviews held after discharge with the survivors of five pairs of patients hospitalized together in which one patient died show that the death of another patient having bone marrow transplantation has a major impact on the surviving patient. Early identification develops between patients, and after one patient dies there are attempts at distancing and denial of identification, survivor guilt, and fears of a similar fate that continue after transplantation. Healthy reactions are differentiated from nonadaptive reactions. Similarities to other forms of survivor guilt are discussed, including the guilt of the medical staff.