Choosing to Care for Children Who Might Die: Conversations with Pediatric Residents.

Abstract

This essay evolved from observations that pediatric resident physicians' experiences with patient deaths might influence their career paths after completing residency training. The author's journey as a physician led her to wonder whether young pediatricians who gravitated toward careers in primary care had qualitatively different experiences with death and dying during their medical training compared to those who chose fields in which they were more likely to confront death and dying on a regular basis, such as pediatric critical care, neonatology, or pediatric oncology. Ten pediatric residents agreed to participate in conversations that were then expanded to encompass related concepts of "devastating diagnoses" and of "giving bad news." Three central themes-the privilege of supporting families through difficult times, the challenge of navigating between expectations and uncertainty, and the resilience of children experiencing illness-emerged as having profoundly influenced pediatricians' understanding of their professional journeys and identities.