Grief, of course, is a luxury reserved for those who do not have a full clinic. The day after my friend died, I looked at my schedule, and I sighed. I sometimes joke that there are days when I wish I could tell patients: I know you need me to be sympathetic. I just don’t have it in me today. Come back tomorrow; I’m happy to be sympathetic then.
I was about to start a week’s worth of those days. The patient with intractable pain whose orthopedic surgeon kept insisting had an active rheumatic disease as the cause. The patient with polymyalgia rheumatica who flew up from Florida because he is convinced he now has giant cell arteritis. In a normal week, I would just go with it, but now, I really just wanted to be left alone to wallow in my thoughts.
The Trauma of Sudden Death
I learned that I was experiencing the consequences of sudden death. I was previously familiar with the term sudden cardiac death, which typically refers to an arrhythmia. Sudden death refers to anyone who dies unexpectedly, most often from an accident, homicide, suicide, disaster or an acute medical condition.2 The concept exists hand in hand with sudden bereavement, which is the mourning a survivor experiences when he or she has not had time to prepare.