Most of us in healthcare are familiar with On Grief and Grieving that David Kessler wrote with Elisabeth Kubler-Ross based on Kubler-Ross’s work with the terminally ill. People experience grief much like they experience death in five stages. The stages are anger, denial, bargaining, depression, and acceptance. As David Kessler points out these stages are not meant to be a tidy process for getting through pain quickly and neatly. People grieve in their own unique ways. 

Recently Kessler added another stage to grieving: meaning. This is discussed in his book, Finding Meaning: The Sixth Stage of Grief.

I’ve been thinking about the loss many of us have experienced over the past year or so. While loss can include the death of a loved one, it can also include a loss of hope, a financial loss, opportunities lost, a lifestyle loss, or maybe it’s something more nebulous like a loss of faith in humanity. 

If we use Kessler’s definition that grief always involves a change we didn’t want and has to do with a connection or love that has been lost, then it’s safe to say that most of us are grieving. 

How can we find meaning as you learn to process a loss in your life?

So you’re not confused, I’m not talking about finding meaning in the terrible thing that happened such as the pandemic, the meaning is in us. It’s what we do after suffering a tragedy or loss. How can you not make yourself smaller in response to what has happened, but how can you grow from the experience? 

For me personally, in my career, I’ve experienced the loss of seeing my patients face to face and connecting with them the way I once did. I have felt hopeless at times, wondering if my patients will be able to achieve health and wellness in their lifetime.  

Maybe your career losses are similar to mine and you don’t want to accept things as they are. You’re ready to grow as a professional by finding some meaning. Because it’s personal, I would not assume to know how you’ve processed the losses in your life. But if we focus our attention specifically to healthcare work we can learn from our shared experiences. 

LOSS OF CONNECTION WITH OUR PATIENTS

For us pharmacists, you may have noticed that your patients didn’t stop in the pharmacy as often. Maybe they went through the drive-through window or you started delivering their medications. These changes were expected, but you may have been surprised to learn just how much you rely on nonverbal communication. As someone who picks up on non-verbal communication, you missed being able to see facial expressions and read body language. 

I’ve also noticed a different kind of disconnect with how I connect with patients. Many patients have a hard time listening because they seem distracted or angry. They’re just not as easy to talk to as they once were. Maybe you’re responding to this by getting angry yourself. Maybe you’ve found it easier to just avoid your patients. Maybe these once seemingly rational people you take care of are grieving. If you’re responding with anger, denial, or bargaining, then you are grieving too. From that perspective, you can see how you are connected to your patients. We are all suffering some form of loss. There is no shame in this. Where can you go from there? What kind of healthcare leader can you be with this understanding?

LOSS OF HOPE FOR HEALTH

As healthcare leaders, our patients need us now more than ever. Have you found that your patients have gained weight? Do they take more insulin and more antihypertensives? Have you noticed the increase in the number of antidepressants you dispense? Some of you have connected the dots: the diseases that so many of your patients have also make them most vulnerable to the virus. 

What purpose could it serve to see all of this sickness? Again, this is personal for you, but here are a few things I’ve found. Sometimes it takes the loss of something, to really appreciate what we have. You can remind them that all is not lost. They can regain their health maybe with even more resolve because they’ve seen or experienced what the loss of health can do to a person. 

It’s time to be supportive, practical, and steadfast in your resolve to help people get well. One patient recently lamented that a relatively healthy and younger member of her family died. She took this loss and translated it into, “There is no hope for me. I’m older and sicker than he was.” We talked a little bit about how fear and loss together can seem impossible to overcome. Finding meaning won’t take away the pain of losing a family member, but it can soften it a little bit. Can you find meaning in being a better listener? Can you see where empathy can make you and your patients feel better as we all take the next steps toward getting well? 

LOSS OF CAREER SATISFACTION

Your job was stressful before, and then with the added pressures of all the emotional, mental and physical strain that that pandemic took, you can accept (the former last stage of grief is acceptance) that you will spend the remaining years of your career in a state of burnout. Instead of stopping there, are you willing to see if what you’ve experienced can serve a purpose? Maybe you, like your patients, haven’t taken as good care of yourself as you wished you had during these unprecedented times. You may have forgotten that you’re more than a healthcare provider. You’re a human being with real human needs for beauty, connection, good food, water, and rest. Having experienced the extreme of not being able to take care of yourself, can you find a new appreciation for your own well-being? 

Please know that you are not your work. Work is a big part of who you are but it’s not the entirety of you. This perspective can make you better at your job. Some perspective is good for you. You’re life as a human being and not just as a healthcare provider, has value. You have value. You are worth taking care of. Taking a step back can help you to realize this was a gift. What can you do to bring more joy into your life? How can you fill up your senses with beauty a few times a week? What does your body need from you in terms of the food you eat and the number of hours you sleep? 

FINAL THOUGHTS

Meaning connects us to each other and more deeply to ourselves. I think human beings do yearn for meaning. We want to see what one thing has to do with another. We don’t want it all to be pointless and to continue on with loss while stuck in acceptance. And when you are ready to take on this sixth stage of grief, let go of any judgment, and be gentle with yourself. 

We don’t have to accept this state of the world, the state of our careers, or the state of health as the end. All of what has happened can have meaning and can serve us as we grow as people and practitioners.