Pathways (by Kathrynn Thompson)

I recently gave a presentation to our internal medicine residents. I was chosen not because of my clinical expertise but because I am a cancer survivor and they wanted to hear about my personal cancer journey and what healthcare providers can do to help. As I was preparing for this I revisited some of my grief experiences. The conceptualization of grief is changing from stages of grief as described by Kubler-Ross and others to individual pathways of grief (ELNEC 2016). Certainly the stages described by Kubler-Ross and others can still be used to identify some of the symptoms each of us may experience on our individual grief pathway. Conceptualizing grief as a pathway allows us to see grief as an ongoing process and not a linear process with a distinct end.  Sometimes as patients and healthcare providers we get great insights from the most unusual places. I recently watched an episode of NCIS where one of the main characters is talking to someone who had just lost his father and states (and I paraphrase), “When you are in hell, keep walking”. As a survivor and a healthcare provider I think this is a good suggestion. When you are in the depths of grief you need to keep walking the pathway. Grief needs to be experienced for healing to occur.


We, as healthcare providers, are used to “fixing” things and grief cannot be “fixed” in the short-term. Teaching our patients about grief as a pathway that must be walked despite the pain is a good place to start. The goal is to support the patient and the survivor in telling their story and to:

    • Feel the loss.
    • Express the loss.
    • Move through the tasks of grief.
    • And then communicate assessments/findings to the interdisciplinary team. (ELNEC 2016)