RP101 – Loss

Session Readings


Human Context in Healthcare – Session #4:
Loss: When My Patient Dies

Panel Discussion: 2/9/2015; 0730-0900
Papers Due: 2/11/2015 @ 1200
Small group Discussion: 2/19/2015 (SoM); 2/20/2015 (GSN); 0730-0900

By this point in our lives, we have all experienced loss in one form or another. In our roles as healthcare providers, one of the situations in which we experience loss is when our patients die. While we encounter such situations more often than others, the significance of these experiences and their potential impact on our lives and our practice of healthcare is no less profound. Consequently, pausing to consider our own views on death and dying, reflecting on how we have reacted to such situations in the past and may react in the future, and examining the way these reactions might impact the way we care for patients in a variety of circumstances is important. Through this process, we have the opportunity to gain greater self-awareness and improve the quality of care we will offer in the future.


Preparation for the panel
Prior to the panel, reflect on your conception of death and your past experiences with loss – including those involving the death of friends and family as well as patients, if you have had such experiences. In addition, reflect on your perspective on death of people at various ages, including children; concerns about your own competence when caring for a patient who dies; thoughts about your own mortality and fears about death; and your views on end of life care.

Reflective Essay (R.S.I.P. format)
Reaction: As stimulated by the panel and supplemental resources, identify your thoughts and reactions, including each of the following:

  1. Your thoughts and feelings about being responsible for the care of someone whose decision to pursue or decline life-prolonging treatment differs from what you feel is best
  2. Your reactions to two or more of the panelists’ narratives or supplemental resources that struck you as particularly poignant

*Note: When writing this section, list your affective reaction followed by 1-2 lines describing those aspects of the panel/resources that evoked your reaction.

Sources/Your Story: Through the medium of your personal narrative, explore the sources of these thoughts, feelings, and reactions. Your narrative must include specifics and be written in the first person. Your sources will likely include one or more of the following:

  • your perceptions of how loss in general and death in particular were/are viewed in your family of origin, faith group, community, and among your peers (both growing up and now)
  • your perceptions of how loss and death are addressed by your faith group
  • your experiences to date with loss in general and death in particular
  • your perceptions of how loss and death are viewed in the military and medical communities

Implications: Keeping in mind what your reactions and the sources of those reactions reveal about your perspective on loss and the death of your patient, analyze both the positive and negative implications of this perspective for how you might care for patients in the future.

Plan: Develop a realistic and specific plan to mitigate the negative and enhance the positive implications described in your Implications section.


Below are five pieces related to loss for your consideration. I believe that you will find them interesting and insightful, and that they will also help you to reflect on your personal views of loss including experiences when your patients die.  You may find the article “The Day I Started Lying to Ruth” to be of particular value to read prior to the panel.

Adam K. Saperstein, MD
Dept. of Family Medicine

TEDxLet’s Talk About Dying by Peter Saul A discussion of the success of intensive care and how that has impacted how we die, and how we react to others’ death in the 21st Century.
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YouTube“Last Day” - Chapter 21 - Charlotte’s Web - As Read by E.B. White Many of us first confronted death when reading books in our childhood, including E.B. White’s classic, Charlotte’s Web. Those of you who are parents have or will soon have the opportunity to re-read this with their children, something that will vividly demonstrate how one's individual context can change over time. Here, for your contemplation of your reaction then and now, is chapter 21 – Last Day, read in the author’s voice.
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NPR"Still Point": A Mediation on Mothering a Dying Child - Emily Rapp The struggles and emotions experienced parenting a child with Tay-Sachs disease.
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TEDxShould We Be Afraid of Death? by Stephen Cave Why are humans afraid to die? Four stories we tell ourselves about death in reaction to our fear.
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NY_Mag_com_lockupThe Day I Started Lying to Ruth by Peter B. Bach An oncologist’s account of losing his wife to cancer. An intimate look at how healthcare, relationships, personal desires, expectations, and promises all intersect and influence our lives.
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