{"id":3042,"date":"2020-11-10T16:40:50","date_gmt":"2020-11-10T21:40:50","guid":{"rendered":"https:\/\/blogs.nejm.org\/general-medicine\/?p=3042"},"modified":"2020-11-10T16:49:17","modified_gmt":"2020-11-10T21:49:17","slug":"why-i-wore-all-black-that-day","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/","title":{"rendered":"Why I Wore All Black That Day"},"content":{"rendered":"<div id=\"attachment_2965\" style=\"width: 135px\" class=\"wp-caption alignright\"><a href=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/08\/Sneha-Shah-1.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-2965\" class=\"size-full wp-image-2965\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/08\/Sneha-Shah-1.jpg\" alt=\"Sneha Shah, MD\" width=\"125\" height=\"150\" \/><\/a><p id=\"caption-attachment-2965\" class=\"wp-caption-text\">Dr. Shah is a Chief Resident in Internal Medicine at the University of Colorado.<\/p><\/div>\n<h4>The death of Ruth Bader Ginsburg<\/h4>\n<p>Even the sharpest dressed attendings come to work donning scrubs in the time of COVID. I was no exception. Halfway through my 2 weeks on service, I appreciated the extra comfort my blue scrubs provided. Then, on September 19<sup>th<\/sup>, I wore all black. Those accustomed to seeing me in scrubs commented that I was dressed \u201cnicely.\u201d But for me, it was no ordinary Saturday. It was the day after the death of Ruth Bader Ginsburg (RBG).<\/p>\n<p>RBG served on the US Supreme Court for 27 years \u2013 1 year short of my current lifespan on earth. It is no secret that Justice Ginsburg fought tirelessly for women during her tenure on the Supreme Court. I cannot help but think that a large part of where and who I am today is due to her dedication to women. As I am not a law expert, I refer you to <a href=\"https:\/\/www.history.com\/news\/ruth-bader-ginsburgs-landmark-opinions-womens-rights-supreme-court\" target=\"_blank\" rel=\"noopener noreferrer\">this article on History Channel\u2019s website<\/a>. But, as this is a blog about the lives of doctors, why am I talking about the death of a lawyer?<\/p>\n<div id=\"attachment_3044\" style=\"width: 225px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3044\" class=\"wp-image-3044\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG-240x300.jpg\" alt=\"Justice Ruth Bader Ginsburg portrait\" width=\"215\" height=\"269\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG-240x300.jpg 240w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG-819x1024.jpg 819w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG-768x960.jpg 768w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG.jpg 960w\" sizes=\"auto, (max-width: 215px) 100vw, 215px\" \/><\/a><p id=\"caption-attachment-3044\" class=\"wp-caption-text\">Justice Ruth Bader Ginsburg (CC license 1.0)<\/p><\/div>\n<h4>Same person, different grief<\/h4>\n<p>Despite my as-yet-short career in medicine, I am no stranger to patient deaths. But the nature of being a physician means one typically needs to move on quickly. The next patient demands your full attention \u2014 cognitively and emotionally. The lack of grieving is rampant in medicine \u2014 as echoed by <a href=\"https:\/\/www.nytimes.com\/2012\/05\/27\/opinion\/sunday\/when-doctors-grieve.html\" target=\"_blank\" rel=\"noopener noreferrer\">this New York Times piece<\/a>. Quite rarely have I let the death of a patient affect me outside of the hospital. If it did, I found an outlet to cope: journaling, a dialogue with friends and family, or distractions. RBG\u2019s death, unlike the deaths of patients for whom I\u2019ve cared, impacted me heavily. I cried on my way to work, I cried in my office, I was somber all day. I wore black to silently mourn. You may not recall, but a mere 2 hours after her death, the media was reporting on ideas about \u2018who will replace her?\u2019 \u2018will she be replaced before the election?\u2019 \u2018what are the pundits predicting?\u2019 Everyone else moved on from her death as quickly as I usually move on after the death of a patient. This bothered me profoundly. It also ignited in me an introspection about whether my approach to difficult moments in the hospital (like death) needs maturation. A topic that a previous chief blogger, Dr. Bhardwaj, <a href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/07\/patient-death-and-physician-grief\/\" target=\"_blank\" rel=\"noopener noreferrer\">wrote about so eloquently<\/a>.<\/p>\n<h4>Making the time and space<\/h4>\n<p>Likely a manifestation of years of suppressing grief as a physician, the death of a woman I admired so much, at a lousy time that was wrought with emotions, unleashed my grief. I find it more important now to start my journey of allowing myself to feel \u201cnegative\u201d emotions <em>in<\/em> the hospital. Luckily, a few of my colleagues have been working on a project to help me to do just this!<\/p>\n<p>Drs. Joanne Chiao and Marissa Martin, residents in our Internal Medicine program, recognized the need for debriefing sessions after traumatic events in the hospital. Their experience was similar to mine \u2014 no time or space to grieve. Adapted from Keene et al.\u00a0 (<a href=\"http:\/\/www.pediatricnursing.net\/issues\/10julaug\/abstr1.html\" target=\"_blank\" rel=\"noopener noreferrer\">Pedriatr Nurs 2010 36:185<\/a>) and assisted by leaders of our More Than Medicine Committee, they developed a debriefing pocket card (original idea derived from Govindan et al. [<a href=\"https:\/\/doi.org\/10.15766\/mep_2374-8265.10809\" target=\"_blank\" rel=\"noopener noreferrer\">MedEdPORTAL 2019; 15:10809<\/a>]).\u00a0I look forward to the resident response to this intervention and their collective debriefing experiences. While the laws assented by Justice Ginsberg are larger in magnitude than a debriefing card, it is by implementing simple solutions that large scale change becomes possible. These small actions multiplied by days and people yield eradication of stigma surrounding physician grief \u2014 especially in the hospital.<\/p>\n<div id=\"attachment_3043\" style=\"width: 604px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/Debrief-Card.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-3043\" class=\"wp-image-3043\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/Debrief-Card.jpg\" alt=\"pocket card to address physician grief\" width=\"594\" height=\"442\" srcset=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/Debrief-Card.jpg 821w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/Debrief-Card-300x223.jpg 300w, https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/Debrief-Card-768x572.jpg 768w\" sizes=\"auto, (max-width: 594px) 100vw, 594px\" \/><\/a><p id=\"caption-attachment-3043\" class=\"wp-caption-text\">Courtesy of Dr. Joanne Chiao, Dr. Marissa Martin, Dr. McHale Anderson, Dr. Adrienne Mann, and Dr. Roxana Naderi.<\/p><\/div>\n<h4>Why I wore black<\/h4>\n<p>A pioneer in her own time, I like to think RBG would be proud of this generation of physicians. We have endured inaction on climate change, faced a politicized pandemic, and been awakened by the social injustice which surrounds us. In speaking up, we\u2019ve been told to \u201cstay in our lane.\u201d I wore black to mourn the silence that fell when a woman died who gave a voice to generations of women. I mourn that she died in a time when we are deprived of acts of comfort like a hug. Being emotional or taking the space to debrief or grieve only makes us stronger physicians. Using RBG\u2019s example, I will no longer remain silent under the taboo of shame surrounding negative emotions in the hospital. I will grieve. And I will wear black the next time I need a reminder of needing to do so.<\/p>\n<p><a href=\"https:\/\/resident360.nejm.org\/\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-926\" src=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2017\/03\/genMedRes360Ad540x250.jpg\" alt=\"NEJM Resident 360\" width=\"540\" height=\"250\" \/><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The death of Ruth Bader Ginsburg Even the sharpest dressed attendings come to work donning scrubs in the time of COVID. I was no exception. Halfway through my 2 weeks on service, I appreciated the extra comfort my blue scrubs provided. Then, on September 19th, I wore all black. Those accustomed to seeing me in [&hellip;]<\/p>\n","protected":false},"author":1306,"featured_media":3044,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[1567,1565,1297,33,37,1566],"class_list":["post-3042","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-about-residency","tag-death-and-dying","tag-grieving","tag-physician-grief","tag-reflections","tag-resident-experience","tag-ruth-bader-ginsburg"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v17.1.2 (Yoast SEO v20.8) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Why I Wore All Black That Day - Insights on Residency Training<\/title>\n<meta name=\"description\" content=\"Dr. Shah mourns the death of Ruth Bader Ginsburg and gives herself leave to mourn other deaths.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Why I Wore All Black That Day\" \/>\n<meta property=\"og:description\" content=\"Dr. Shah mourns the death of Ruth Bader Ginsburg and gives herself leave to mourn other deaths.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/\" \/>\n<meta property=\"og:site_name\" content=\"Insights on Residency Training\" \/>\n<meta property=\"article:published_time\" content=\"2020-11-10T21:40:50+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2020-11-10T21:49:17+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/blogs.nejm.org\/general-medicine\/wp-content\/uploads\/sites\/4\/2020\/10\/RBG.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"960\" \/>\n\t<meta property=\"og:image:height\" content=\"1200\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Sneha Shah, MD\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Sneha Shah, MD\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/\",\"name\":\"Why I Wore All Black That Day - Insights on Residency Training\",\"isPartOf\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\"},\"datePublished\":\"2020-11-10T21:40:50+00:00\",\"dateModified\":\"2020-11-10T21:49:17+00:00\",\"author\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/1ffa2dd16f3542a9070d80729adb14b5\"},\"description\":\"Dr. Shah mourns the death of Ruth Bader Ginsburg and gives herself leave to mourn other deaths.\",\"breadcrumb\":{\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/index.php\/2020\/11\/why-i-wore-all-black-that-day\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blogs.nejm.org\/general-medicine\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Why I Wore All Black That&nbsp;Day\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#website\",\"url\":\"https:\/\/blogs.nejm.org\/general-medicine\/\",\"name\":\"Insights on Residency Training\",\"description\":\"Observation of residents across diverse medical specialties\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blogs.nejm.org\/general-medicine\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/blogs.nejm.org\/general-medicine\/#\/schema\/person\/1ffa2dd16f3542a9070d80729adb14b5\",\"name\":\"Sneha Shah, MD\",\"description\":\"Sneha is a Chief Resident in Internal Medicine at the University of Colorado. She grew up in India, but here in the U.S., considers herself a native of Chicago, Illinois \u2014 a city in which all her sports allegiances lie. A few years after immigrating to Chicago, she also spent time in Milwaukee, Wisconsin, for college (Go Marquette!) and medical school at the Medical College of Wisconsin. She has enjoyed her residency at the University of Colorado and is looking forward to being one of the inpatient Chief Residents, as well as the Chief Resident of Wellness. Her career in medicine will be as an academic hospitalist, with a focus on becoming a clinician-educator \u2014 a forever and unyielding pursuit. She thanks her parents for their sacrifice in forging her success. Sneha currently is in a relationship with Trevor, who is a classical cellist. She enjoys cooking Indian food and tending to her houseplants. You might also find her wielding a racket on a badminton or tennis court. 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