By Allison Campbell

Physicians are very familiar with the pain felt by family members when they lose a loved one.

The families may not realize, however, that the physicians also often suffer an emotional loss when a patient, especially a young one, is lost.

Dr. Lorry Frankel, the Service Chief of the Pediatric Intensive Care Unit at Lucile Packard Children’s Hospital at Stanford, says, “A neonatal death is tragic and extremely disheartening. I lose sleep over it and work hard to avoid it.”

Even the doctors who may appear numb to emotions when dealing with patients, are often deeply distressed by neonatal death.

Dr. Thomas Wisler, a family practitioner at the Palo Alto Medical Foundation, says that dealing with neonatal death is “emotionally more difficult than anything else in my profession.”

The degree of emotional attachment a doctor feels to his patient depends on several factors. In general, doctors become more emotionally attached to patients they’ve treated extensively for long periods of time.

A less obvious factor is that doctors who have been in practice longer may feel more for the patients’ families.

After practicing emergency medicine for over 20 years, Dr. Bruce Campbell says, “Early in my career I was often so focused on the details of providing optimal care/resuscitation that I maintained more personal distance from the situation.

“Now I’m less distracted by facts and formulae and more personally involved with the patient and family.”

Some doctors believe they also grieve more for the families of patients because they have children of their own and therefore more easily identify with the family and can imagine the pain inflicted by its loss.

Dr. Wisler, who is also a devoted father, expresses the importance of maintaining a human relationship with the parents and grieving the inconceivable loss on a parent to parent basis.

Physicians do all they can to save lives and yet modern medicine is not always able to offer the necessary solutions. This can be extremely difficult for many doctors, such as Dr. Wisler who feels “helpless in the situation because for many conditions there’s precious little I can do.

“I am always overwhelmed with a sense of failure, inadequacy and incompleteness.”

Dealing with the families of lost patients is always difficult because they are often in shock and overcome with intense grief.

Dr. Campbell tries to treat the family as he would treat his own family. “If they want to be present while we attempt to resuscitate their baby, they may. I keep them updated on the progress, or lack thereof, of the code blue. After the baby is pronounced dead, I allow the family members time with their little one’s body and de-emphasize our hospital administrative details for a while.”

Families often appreciate the extra time the doctor spends with them after the baby has already died, even though the doctor’s medical duties have been completed and there is nothing more the doctor can do for the patient.

Doctors hold a difficult position, as they must carry on with their work, treat more patients, and fulfill administrative requirements, yet at the same time, they must also take the time to be sensitive to the situation and empathize with the family.

Dr. Frankel says, “The most important aspect of my relationship with the parents is honesty. The family needs to be assured that they have done everything they could and they need to be aware of all the complications with the disease. He strongly encourages parents to work with support groups.

Whether a baby dies from SIDS or from any other unfortunate event or medical condition, Dr. Campbell, who sees about one such case per month, says, “One death is too many.”

Although neonatal death is uncommon, there should still be a network of agencies with the purpose of helping families deal with their loss.

Dr. Frankel says, “Unfortunately we’re not as well prepared for neonatal death as I’d like. We need more support for the families in the forms of hospice, palliative care programs and education for physicians and staff.”

Doctors at Stanford Hospital and other hospitals around the country feel ill equipped to personally offer sufficient help to the families as they prepare for and deal with the deaths. Their professional experience shows them the overwhelming grief and loss the families feel and convinces them that the families need lots of support, preferably from support groups as well as from family and friends.

As for the doctors themselves, they sometimes need to turn to other doctors, nurses, spouses and close friends. For the doctors as well as the families, neonatal death calls for emotional support from people who understand and care.

Allison Campbell is a Stanford University student participating in the community service writing program.