I had a dream last week about one of my first capstone patients. The one who asked me if I knew what I was doing.
Come to find out today that she passed away…last week.
It hit me. Hard.
Maybe I was so affected by it precisely because I thought I could “handle it”. Maybe part of “handling it” is actually letting myself grieve. I’ve been looking ahead to a career in pediatric end-of-life care for so long that when people asked, “Won’t that break your heart?” and I answered “Probably,” I never stopped to think about how that would actually feel.
She was at home when it happened. I hadn’t seen her in over a month. But she was apparently still in my heart and on my mind until the day she died, and beyond.
It sucks. But if I didn’t feel it profoundly, perhaps I shouldn’t be doing this work.

I’m sorry, Teeny. It’s hard. As someone who’s done a bit of pediatric palliative care in my position, I would suggest that you will probably continue to grieve your patients who die–though not all in the same way or to the same degree. My boss (a wise man and formidable clinician) told me around the time I lost my first patient to try to step back and observe how it went for me the first few times, how it felt, what I needed to do to take care of myself, that kind of thing. It was helpful. It’s still hard, but I’ve given myself room and permission, I guess, for it to be different each time. Some touch me more than others, and that’s okay. Hang in there. Thinking of you.