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首页> 外文期刊>The Journal of Graduate Medical Education >Permission to Grieve? “What's Up With That?”
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Permission to Grieve? “What's Up With That?”

机译：悲伤的许可？ “那是怎么回事？”

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Recently, a close colleague—a master clinician and teacher to nearly all in our educational community—passed away suddenly at a young age. He was larger than life; his competence and influence belied his young age. After the announcement was made to the residents, there were a few gasps and quick tears, then a hollow silence filled the room. The designated institutional official (DIO) spoke up: “If Dr O'Brien were here, and saw how quiet we all were, he'd …” his voice cracked, and his eyes filled with tears. “He'd probably say what he has always said, ‘What's up with that?!'” The room's silence gave way to knowing laughter and more tears. Many faculty members later approached the DIO to thank him for showing emotion; as a senior clinician at the institution, his public display of emotion “gave permission” for everyone else to do the same. As the news rippled through our community, the reactions varied: an educator at our institution apologized to those around her when she was unable to stop crying. Another colleague told us about a meeting with his residents during which he consciously debated whether to choke back his tears in front of them or succumb openly to his grief. We were struck by what these reactions uncovered in our environment: that during grief, our human emotions evoked permission, apologies, and debate. We wondered: Are these reactions symptoms of deeper problems in the clinical learning environment? Recent emphasis from the Accreditation Council for Graduate Medical Education (ACGME) on the clinical learning environment is grounded in its correlation with residents' clinical practice years later.1,2 This connection has positive effects: great teaching and patient care in the present time make a difference for patients many years down the road. However, the ACGME has also challenged institutions to consider how learning environments may be responsible for less desirable outcomes for physicians,3 particularly given the disturbingly high suicide rate among physicians.4 Supporting physicians' emotions is central to their well-being. The skill of controlling emotions during high-stakes, emotionally charged situations allows them to focus on their clinical skills and to effectively lead the team. However, it does not change the fact that physicians experience loss in a humanistic way. We realize that our own very present experience of loss is not dissimilar to that of other institutions.5 So we must ask: Do these indicators reveal that graduate medical education has created an environment in which comforting families is essential, but showing our own emotion requires permission? In the wise words of our friend, we ask, “What's up with that?!” Across graduate medical education, we need continued, open conversation about how spiritual and emotional feelings should not be neglected. We must ensure that trainees' and colleagues' emotional and spiritual health are supported before a tragedy makes the lack of such support explicit. We must all find opportunities locally to affirm that emotion is human and honest. If we act now, the profession of medicine has a chance of changing the toxic trends that are becoming all too common to ignore.
机译：最近，一位亲密的同事 - 一位临床医生和老师在我们的教育社区中几乎所有人都在年轻时突然消失了。他比生命更大;他的能力和影响力表示他的年轻时。在向居民宣布发布后，有一些喘息和快速的泪水，然后填补了房间的空心沉默。指定的机构官员（DIO）发言：“如果奥布莱恩博士在这里，并且看到我们所有人的安静，他......”他的声音破裂了，他的眼睛充满了泪水。 “他可能会说他一直说的话，”那是怎么回事？！“”房间的沉默让位于笑声和更多的眼泪。许多教师稍后会致力于DIO感谢他展示情感;作为该机构的高级临床医生，他的公开展示了情感“允许”为其他人做同样的事情。随着新闻通过我们的社区波动，各种各样的反应：当我们无法停止哭泣时，我们机构的教育者对她周围的人道歉。另一个同事告诉我们关于与他的居民会面的会面，在此期间他有意识地争论是否扼杀他面前的泪水或公开地屈服于他的悲伤。我们的环境中未发现的反应是什么：在悲伤期间，我们的人类情绪唤起许可，道歉和辩论。我们想知道：这些反应是临床学习环境中更深入的问题的症状吗？最近强调临床学习环境的研究生医学教育（ACGME）的重点是其与居民临床实践年后的相关性接地.1,2这一联系具有积极影响：目前的教学和患者护理患者多年来的患者差异。然而，ACGME也有挑战性的机构，以考虑学习环境如何对医生的不太理想的结果负责，特别是特别鉴于医师之间的令人不安的高度自杀率.4支持医生的情绪是他们幸福的核心。在高赌注中控制情绪的技能，情绪充电的情况允许他们专注于他们的临床技能，并有效地引导团队。然而，它不会改变医生以人文的方式遭受损失的事实。我们意识到我们自己的损失经历并不不同于其他机构.5所以我们必须询问：这些指标是否揭示了研究生医学教育创造了一个环境的环境，却展示了我们自己的情绪所必需的环境允许？在我们朋友的明智之语言中，我们问：“那是怎么回事？！”跨越研究生医学教育，我们需要继续，开放对话时应如何忽略精神和情绪感受。在悲剧使得缺乏这种支持明确方面，我们必须确保受过培训人的情感和精神健康得到支持。我们必须在本地找到机会来肯定，情绪是人类和诚实的。如果我们现在采取行动，医学的专业有机会改变毒性趋势，这是忽视的全部共同点。

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