Coping with Death as the Doctor in the Family
This month's reflection is a personal one. I recently lost my brother Tom unexpectedly, and in the hours that followed, I found myself carrying something many physicians know but rarely name - the particular weight of being the doctor in the family when grief arrives. This is a piece for any physician who has ever had to hold space for everyone else while quietly searching for space of their own.
About four weeks ago, my wife and I welcomed my remaining siblings and their spouses to our home in Seattle for a long-awaited sibling reunion. We gathered on Whidbey Island, a beautiful spot overlooking the Puget Sound and the Olympic Mountains; a setting I had been eager to share with them for years.
There were originally seven of us growing up together in a small row house in Washington, DC. I’m the youngest. My oldest brother was nearly twenty years older than me. Four years ago, we lost him after a long battle with multiple chronic illnesses. This sibling reunion felt especially meaningful because of that absence—and because getting everyone together from across the country had become increasingly difficult.
My brother Tom was supposed to be there.
For some time, Tom had not been feeling well. He had been dealing with several concerning symptoms and was in the midst of ongoing medical evaluations, still without clear answers.
At the last minute, he decided not to travel. He didn’t feel strong enough to be so far from home in case something worsened.
When he texted to say he wouldn’t make it, I called him right away.
Like other members of my family over the years, Tom often reached out to me as the physician in the family. We talked through how he’d been feeling, what his doctors were considering, and what might come next. Everything sounded thoughtful and appropriate, yet I couldn’t shake a feeling of unease that there was still something unresolved.
As we ended the call, he seemed at peace with staying home. He told us to enjoy our weekend together and promised we’d connect virtually for our usual family storytelling.
Two days later, he was gone.
After several failed attempts to reach Tom over the first 2 days of the reunion, my brother Steve finally called his wife. She answered and quietly told him that Tom had died earlier that day during a medical procedure.
We were stunned.
There we were—together in one of the most beautiful places imaginable—suddenly sharing devastating news no one expected.
And inside me, multiple reactions arrived all at once.
I was grieving the loss of my brother.
I was shocked by how quickly everything had unfolded.
I was trying to understand medically what had happened.
I felt frustrated that so much remained unclear.
And somewhere beneath all of that, I felt a quiet but familiar sense that perhaps I had somehow failed him.
When illness and death hit close to home
As physicians, we encounter death throughout our careers.
For most of us, it begins in medical school. It becomes more frequent during residency. And depending on our specialty, it remains a regular part of practice for decades. Over time we learn how to function around death. We pronounce it. Document it. Explain it to others. Then often, we move on to the next patient, the next page, the next responsibility.
Rarely do we receive much guidance on what to do with what we ourselves are feeling.
When serious illness or death enters our own family, the experience can feel entirely different.
Suddenly we are no longer only clinicians. We are sons and daughters. Brothers and sisters. Spouses. Parents.
And yet we are still often expected to be the medical interpreter in the room.
We become the person others turn to for answers:
What does this test mean?
What questions should we ask?
Does this treatment make sense?
What would you do?
We may find ourselves explaining the decisions of other physicians, advocating within a complicated medical system, helping loved ones make difficult decisions, and managing the emotional reactions of everyone around us.
All while carrying our own emotions.
Often, it feels easier to stay in the clinical lane—to focus on the data, the timeline, the unanswered questions—than to fully feel the grief underneath it all.
For physicians, intellectualizing can become a refuge.
But grief has a way of waiting for us.
And when we continually postpone our own emotional experience in service of caring for everyone else, it doesn’t disappear. It accumulates.
Letting go of the role
After speaking with Tom’s wife and daughter and learning what little was known, we ended the call and turned toward one another.
What followed felt deeply familiar and deeply human.
We prayed.
We cried.
We told stories.
We ate and drank.
We held each other.
In our family, this is what we do when someone dies.
And somewhere in that moment, I felt myself loosen my grip on being “the doctor.”
My siblings didn’t need me to have the answer.
There wasn’t an answer to give.
What they needed was a brother.
Someone willing to grieve with them.
Someone willing to be present.
Someone willing to let himself be held too.
So, I cried. I held onto my wife. I prayed. I told stories about Tom. I let myself feel the sadness, the confusion, the gratitude, and the mystery of it all—without needing to resolve it.
I did the best I could.
And I’m still doing that now.
A reflection for physicians
Many physicians become “the doctor in the family” by default.
It can be a privilege. It can also be a burden.
We are often asked to carry knowledge, responsibility, and reassurance for others—sometimes at the very moment we are carrying our own heartbreak.
And because we are so accustomed to being the steady one, we may forget that we also deserve support.
Sometimes the hardest part is not answering everyone else’s questions.
It is finding space to hear our own.
This is often the work that emerges in coaching conversations—not fixing grief and not solving the unanswerable—but making room for reflection, for complexity, and for the emotions physicians have learned to set aside in order to keep going.
If you have found yourself carrying the weight of illness, death, responsibility, or grief—whether from caring for patients or caring for your own family—you don’t have to carry it alone.
What has it been like for you to be the physician in your family when illness or death enters the room?
Be kind to yourself.
Dr. Joe