Davis, T. Death in paediatrics, Don't Forget the Bubbles, 2014. Available at:
It must be so difficult working in paediatrics, isn’t it? Seeing all these sick kids must be heartbreaking.
It’s been 11 years since I started working in paediatrics, and I get asked this question regularly by my non-medical friends.
And, to be honest, I’ve never found it that difficult. Sure, children die and it’s upsetting. But it doesn’t happen that often, and mostly they do get better. As a paediatric doctor, you learn to cope with the occasional, upsetting tragedy.
That was until I did my six months PICU.
The volume of major illness and death and the intensity of the work is emotionally and psychologically draining. Very bad things happen to very lovely families.
In my entire medical career, these six months have been the best learning experience of my life. The procedures, high stress situations, decision making and even dealing with difficult conversations will all make me a better doctor when I return to my home territory, PEM.
It’s taught me a lot about families – how couples cope with fear and loss and how their siblings make sense of what’s happening around them. Most of us will not have to face such a personal, confronting situations and, I hope, if it ever happens to my family I will be able to hold it together like so many of the families I’ve met.
PEM allows us the privilege of knowing families at their most vulnerable moment, but PICU takes that to a whole new level. We are literally sharing the worst moments of their lives with them. And we need to handle that well. Our training doesn’t prepare us for what to say or how to act, and I am by no means perfect. Each experience makes us stronger and better at our jobs and able to improve on the next experience and the next interaction.
PICU also teaches you about yourself – how do you react at times of extreme stress? Can you keep cool in a crisis? For most EM docs (and thankfully for me too) the answer is, and should be, yes.
But what happens afterwards, when it’s all over?
The recent Beyond Blue survey showed that doctors suffer from more mental health problems than the general population, yet we are less likely to seek medical advice.
During my time in PICU, after all the resus scenarios and difficult situations, I have never once been asked by a senior doctor – are you ok? There has been no medical debrief and no discussion. In fact, in my whole career in medicine, I can’t remember ever being asked ‘are you ok’?
It seems so basic and human, so why don’t we do it?
An excellent post by The Endocrine Witch highlighted this issue recently. We need to learn to look after each other more and specifically, senior staff need to take responsibility for debriefing and talking about the emotional impact with their juniors.