Dealing with Death and Grief in Medical Education

Dr. Brendan Kelly, Associate Director of Baystate’s Medicine-Pediatrics residency, a master clinician and mentor beloved to both his colleagues and trainees, died suddenly last year.

His death was announced at an emergency hospital-wide meeting at which the DIO’s eyes filled with tears when speaking about him.

When the news spread, one educator apologized for not being able to stop crying, another debated whether to choke back tears or openly show his grief. Many faculty members thanked the DIO for giving them permission to show their emotions.

Wary of Emotion in a Clinical Learning Environment

These reactions—debate, apologies, seeking permission—prompted Rebecca Blanchard PhD, Senior Director of Educational Affairs, and Kevin Hinchey MD, Chief Education Officer, to write a letter to the editor of the Journal of Graduate Medical Education asking whether the reactions of their faculty were symptoms of deeper problems in the clinical learning environment.

Drs. Hinchey and Blanchard acknowledge that controlling emotions during high stakes emergency medical situations is a valuable skill that allows physicians to focus on clinical decision-making and to be effective team leaders.

But they ask whether suppressing emotions in a clinical learning environment contributes to toxic trends identified by the ACGME, such as the increasing rate of physician suicide. Adding that expressing emotion is human and honest, they affirm that the emotional and spiritual health of both trainees and faculty must be supported.

Channeling Grief Appropriately in Residency Training

Dr. Michele Gortakowski, who was in the med-peds program at the time of Dr. Kelly’s death, reported that residents reacted with “shock, disbelief, and overwhelming grief.”

Saying that it is very important to debrief and process these types of emotional and stressful situations, she added that residents were afforded “several opportunities to meet with faculty, chief residents and each other to grieve, share stories and support each other.”

They also came up with a tangible way to express their grief and memorialize him. Wanting to buy something for the playroom of the Baystate Children’s Hospital that would be a symbol of his continuing presence, med-peds residents took up a collection and purchased a fun house mirror. “It fit his personality,” Gortakowski said.

The mirror was unveiled at a dedication ceremony to which all pediatric attendings, pediatric and med-peds residents, and other faculty and staff were invited. Dr. Kelly’s wife and children also attended.

“Patients and families love the mirror—we’ve seen children of all ages giggling in front of it,” said Jessica Hagerman, Child Life Specialist at the Children’s Hospital. 

“I think the staff, residents and faculty who knew Brendan love it just as much! Not only because it’s fun, but because it’s an everyday reminder of the unique spirit and energy that Brendan brought wherever he went.”