Death, dying and the neurosurgeon: a trainee’s perspective

Neurosurgical trainees face many challenges, both personal and professional during their training. By far and large, undergraduate and postgraduate medical training prepares you for the academic commitments faced during one’s training. However, precious few have had formal training in dealing with the dying patient or for that matter in helping bereaved relatives cope with impending loss or the death of a loved one. This article will attempt to highlight some of the aspects of death and dying from the perspective of the neurosurgeon and hopes to make useful suggestions on coping strategies for the patient, the relatives and indeed the physician. CLASSIFICATION OF LOSS AND PERSONS AFFECTED Coping with loss in the field of neurosurgery can be artificially divided into three main categories, the patient, the patient’s relatives and the caregiver. Within each of these categories lie two broad artificial sub-headings; expected and unexpected loss. A compassionate approach is required to deal with all concerned within each of these areas. Unexpected events are naturally more difficult to cope with than events that are planned for in advance. Support systems are required for each group, regardless of age and experience of dealing with loss, be it loss of independence, terminal illness, death and dying. An attempt to classify illnesses into these groups is illustrated below.