Coping with Loss in Medical School

Coping with Loss in Medical School

Backstory (to skip, scroll down to On Grief)

It’s a hot afternoon at Benito Juarez elementary. Class ended a couple hours ago, but the fun had not ended yet. My cousins and I were in the YMCA after-school program, where we would spend the rest of the day until gong gong (grandpa) picked us up around 4-5 pm. The YMCA offered a variety of different activities to keep us busy. Sometimes, arts and crafts or educational presentations. Other times, just free time to mess around on the playground.

More often than not, I would be on the playground, sitting on the swings with my friends, listening to them talk about cute boys (gong gong did not allow me to have opinions on boys). Then I would hear someone shouting in the distance, “TING TINGGGG!” I would turn around and see gong gong standing on the other side of the quad, near the tables where the YMCA teachers sat watching us. Both of his arms would be waving in the air, trying to catch my attention. That was the signal to go home.

With some variation in between, each day pretty much started and ended the same: with gong gong. He dropped my cousins and I off at school each morning and picked us up in the evening. Without fail. Always on time. Every time.

That’s the thing with gong gong. Every time I came home, every dinner we had, every birthday celebration, every holiday, every graduation, he was there. He couldn’t attend my white coat ceremony (due to underlying health conditions), but he promised he would work on his health and be there for my medical school graduation.

Gong gong’s death came unexpectedly early. Death and dying is not a foreign concept to me that I shy away from because I am interested in geriatrics and palliative care. But grief is different.

Grief is such a visceral emotion. Universal, but experienced differently. It’s unique in that way. I had encountered grief before when deddy died a couple years ago, but this time it felt different.

Sometimes I feel like people wonder why I feel so close to my grandparents and the answer is simple. My relationship with gong gong and po po (grandma) dates back to my birth, from po po showering me as a little girl, to grandpa waking me up in the middle of the night to give me my asthma meds. My grandparents were my primary guardians/caretakers, not my babysitters. I didn’t go over to grandma or grandpa’s house just for the weekend, as many of my friends did. I didn’t just visit them once every few months in another country. I lived with them for the majority of my life, saw them every day, and ate dinner with them every day.

It is said that your early childhood experiences from birth to the age of 12 has a significant emotional and psychological impact on you. I’m not going to discuss my history with my parents in detail, but growing up, I had always harbored some feelings of abandonment. No matter how much I tried to shake it, I couldn’t. It wasn’t until college that I moved on from it, that I realized my grandparents had done such a loving job of filling that void for me.

It is normal that some children grow more independent from their parents or primary guardians, or sadly, more distant. But for me, the older I grew, the more attached I became to them. So in hindsight, it makes perfect sense to me why grief felt different to me this time, why it had such a strong hold on me.

After gong gong died, I didn’t know whether I could still stay in medical school because I had lost motivation. Much of my motivation for working hard had come from him. The whole reason why I switched from pharmacy to medical school was to pursue geriatrics. And the whole reason why I wanted to work with geriatric patients was because of him. Every single older person I saw on the street and in the hospital reminded me of him. I mean, just every little thing reminded me of him and brought my eyes brimming with tears. That was the hardest part of all of it. Luckily, a loved one intervened to remind me that I need to do what I have always done. We need to do what we always do, that is, to transform our setbacks into motivation. Even though I lost my main motivation, I found a new one.


On Grief

Grief is like a living, breathing thing. If you’ve ever watched Fantastic Beasts, one of the characters, Credence, harbors this dark, parasitic force called the Obscurus, which is similar to how I think of grief.

Like I said, grief is so visceral. It gnaws at you from the inside out, consuming you. It wants to be understood, but at the same time, it is angry and sad. Because it knows that only others who have harbored the same kind of grief before, can truly understand. And there aren’t many who do yet. So if grief cannot be understood, then it demands to be heard at least.

It is personal. Grief is yours and you own it, no one else.

Lessons I Learned on Dealing with Grief

  • Take your time and do not rush or try to skip the grieving process.
    • No one is immune to grief, even if we try to be! It will manifest itself in one way or another.
    • If you try to skip the grieving process, you may be stuck in one stage, making it hard to recover. For me, this was anger. For a long time, I let my anger simmer inside. I thought I could just go about medical school and keep my mind off of it, then I would go back to normal with time. I didn’t take a leave of absence, even though I should have. (Also, I did not want to pay an extra semester of tuition lol).
    • Then, I started having more and more days where I just felt like I hated the world. Hated everyone. Even though I didn’t; it was grief.
    • Please consider taking a leave of absence to heal if you need to! Nothing is worth compromising your mental and emotional health <3
  • Do not blame yourself, or try not to!
    • I think this is the hardest part. I say “is” because I am still working on this myself.
    • I could have done more to prevent X from happening. And if only I had done Y, then Z wouldn’t have happened. Yes, but also no. No one knows whether you could have prevented something from happening or not.
    • Unless you directly, I mean directly harmed them, then no, it was not your fault!
  • Do not shut out the people who care about you. Do not push away your friends, etc.
    • Of course, people need time alone to digest what has happened. But after a while, it becomes maladaptive. If you have not progressed in 6 months, then clinically, bereavement can now be classified as depression (if other criteria are met. if interested, you can learn more about it here).
  • Spend time with those who generally understand grief itself.
    • If certain people feel uncomfortable being around you during this time, then they are not the people you want to talk to. It’s not their fault. Grief is complicated, but just distance yourself until you are ready.
    • The right people are the ones who reach out first, who offer their company whether it makes them uncomfortable or not.
  • Spend time with those who understand YOUR grief.
    • For me, that was, of course, my family. Specifically, my sister (technically cousin, but we don’t call each other that lol). She was my person. She knows exactly how I feel because she lost her father (my uncle, who I call deddy).
    • It’s okay to reminisce and cry together.
  • Seek resources or therapy early on.
    • The stigma surrounding mental health in Asian cultures is real and can be challenging to overcome. Some Asian people do not believe in mental health or see it as a sign of weakness.
    • Because I come from a conservative Asian family AND I am a medical student, I convinced myself that I didn’t “need” therapy.
  • Journal, write, and/or talk about the fond memories, not just the negative.
    • This is something my therapist recommended. I told her that I can’t think about the memories because I cry every time. She said, “That’s the point!” Eventually, grief runs its course and you are able to simply talk about that person, the memories, and smile.
  • Let your friends and family know what you need.
    • Do you need time alone for a bit?
    • Do you want someone to check in with you after a few weeks?
    • Do you feel too tired to cook today?

How to Support Someone Who is Grieving

  • Do not make this about you! Do not say, “I know how you feel” or anything along those lines.
    • Unless you have been through exactly what they have been through.
    • Bringing your own experience is not what people want to hear!
  • Reach out first; do not wait for them to reach out to you.
    • It goes both ways, but many times, people who are grieving do not reach out, even though they should!
    • Reaching out first is one of the best ways to show your support.
  • Offer to listen.
    • When someone is grieving, there is so much they want to say and to get out, but they don’t know how. Sometimes just saying, “You can say anything you want right now. I can just listen” allows them the freedom to let it all out if needed.
  • Ask questions, if it’s okay.
    • Even if they cry when they think of that special person, sometimes they just need a good cry and sometimes they just want to talk about that person. It’s just a way of honoring him/her.
    • But first ask if it’s okay to talk about that person.
    • Then you could ask, what was his/her favorite hobby?
    • What is your favorite memory with him/her?
    • What line of work was he/she in?

Resources for Bereavement

  • Tear Soup by Pat Schweibert and Chuck Deklyen
    • Yes, it is an illustration book that looks like it is for children. But don’t be fooled! I felt so much better reading it. I
    • If you are in Richmond, VA, I have a copy if you want to borrow it!
    • It also has a list of resources at the end.
  • Contact your school’s counseling office.
    • This can be hit or miss, but usually they are able to provide you with some counseling or a list of outside services.
  • Google local bereavement support groups in your area.
    • Some are free, some are paid. Support groups are actually common and differ by area. It’s a great way to share your grief with others if you want.
  • Check out psychologytoday.com and find therapists that are on a sliding scale, if money is an issue or your insurance is being difficult.

Feel free to reach out to me if you have any questions. I hope you found this helpful. If you ever need a listening ear, I can be that 🙂

With lobe,

Kelly

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Kelly
Kelly

Internal medicine resident physician at UCLA, primary care track. VCU School of Medicine c/o 2022. SoCal born and raised.

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