Imagine sitting with a trusted colleague in a comfortable, safe environment and being invited to share your grief stories. We all have such stories — likely many — and they may be personal (the loss of a loved one, a relationship, a self-image, or a dream) or professional (the loss of a patient, a job, a role, or an ideal). For many of us, the idea of holding space to process the grief we have been carrying would not be comfortable or familiar, but it is increasingly necessary.

When we entered the field of medicine, little did we know how prevalent grief would be, or the toll it can take — both professionally and personally. Medical education spends little time normalizing grief as part of practicing medicine. The Accreditation Council for Graduate Medical Education's family medicine program requirements include demonstrating competence to “address suffering in all its dimensions for patients and patients' families,” but not for physicians or other members of the care team.¹

Physicians and trainees may, therefore, be unprepared to process their grief and fear being seen as “weak” or “too emotional” if they openly discuss their experiences. Destigmatizing grief and bearing witness to one another's suffering is important for the sustainability of our work. Doing so can help us validate our experiences, feel less isolated, develop empathy, and move forward without burning out.

WHAT IS GRIEF, AND HOW DOES IT SHOW UP?

Grief is the anguish experienced after significant loss, and it often includes physiological distress, separation anxiety, confusion, yearning, obsessive dwelling on the past, and apprehension about the future.² Family physicians experience personal or professional grief almost daily, but we are not always consciously aware of it.

Grief can manifest in multiple ways:

• Acute grief is defined as tearfulness, sadness, and insomnia as a response to loss, and typically lasts for less than a year,³

• Anticipatory grief involves feelings of loss experienced prior to the expected loss,²

• Complicated or prolonged grief manifests as intense and persistent grief that causes problems and interferes with daily life,²

• Ambiguous grief refers to loss that does not allow for the possibility of closure (many of us experienced this during the pandemic),⁴

• Disenfranchised grief involves a loss that is not openly acknowledged as legitimate by society and is often accompanied by feelings of shame, guilt, and further isolation (this can be a contributing factor to physician burnout).^2,3