Attending memorials for patients

Sometimes you come across something in your medical journals that hits you between the eyes. For me, the New England Journal of Medicine article by Dr. Ranjana Srivastava entitled "The Service" was one such article.

Dr. Srivastava discusses her experience at the hospital's annual memorial service for all patients who died from cancer during the past year. We have such a service at my institution as well. The author writes of her initial hesitation in attending — anxiety over whether she will say the right thing, guilt about not remembering the family members and concern about embodying the failure of the medical system to cure their loved ones' cancers. In the end, the experience ended up being as therapeutic for her as it was for the families. I've been there — sitting in my car in the funeral home parking lot, wondering if I should go in or not. In the end, I have not yet regretted one wake or memorial I have attended.

Another recently published medical journal study echoes what I have thought about work-hour limitations. It concludes that restrictions on resident work hours produces undertrained physicians. So, either we must lift the work-hour restrictions (which is unlikely) or extend the duration of training. Because right now, we are putting patients at risk by producing poorly trained physicians who just haven't seen enough patients to adequately develop good judgments about patient care.