Dear Grief,

I have decided this year that it is time I come to terms with my emotions. I am ready to face you. I am ready to confront you in a way that brings you out in the open. I am tired of hiding from you and feeling shame about having you perpetually in my thoughts. You are a heavy weight that I carry with me, and I am ready to shed that weight. I know we have come to coexist, but I think it’s time we face each other. 

Grief, I once felt you only temporarily. I could feel you present, then was able to resolve our differences and would see you only occasionally. Now, you have been with me constantly, and I am beginning to realize how dysfunctional we have become in this relationship. The COVID-19 pandemic really changed things for us, like it did for so many people. I am thankful for remaining healthy during that time, as did my family, but you brought destruction in other ways. The life I imagined began to change, and I began to grieve that idea of what I thought about myself and who I was becoming. I thought I was just mourning the process of the pandemic; the death, the despair, the loss we all felt. That was the way I was supposed to feel, right? But deeper than that, I mourn the way we all felt: alone. Despite being happily married and a mother of two healthy children, I was pregnant during the pandemic and you became such a force with me. How could I bring a new life into the world when I was not even confident I wanted to live this life? Such a dark world to enter and such a devastating time. The thought of being so alone was devastating. Alone for my appointments, alone at work, alone caring for my kids, and alone in my heart. If I was alone, I could not spread the deadly virus. If I was alone, no one could see me crying, overwhelmed, and scared. When I was alone, you were right beside me, whispering in my ear that it was OK to feel your presence. But now I see that has become pathologic, and now I am finally asking you to leave. 

Grief, you knew the right way to comfort me around my family. As I missed caring for a loved one going through a cancer diagnosis and chemotherapy, you let me lean on you. I was raising three young kids, in a new city, with a new job, and you told me it was OK to miss out on important milestones. Caring for those we love is painful at times, but I missed time and connections that I will not get back. I am still working through the pain of that. You also sat beside me while other family members have been battling addiction and struggling with dementia. I am reminded that the person in front of me is not actually them anymore, but a shell of the person they once were. I grieve the idea of what those relationships might have been like in happier times. I still see so much darkness in their eyes, and this I am afraid will last an eternity. How long can you mourn the loss of a person’s life while they are actually still living? You know the answer to that, and you would say forever. 

Grief, we have to have a talk about my career. I know that I can choose to feel my feelings, but you are very powerful here. I did not become a physician to fill out endless data points on a computer and hours upon countless hours of paperwork. My expertise is questioned constantly in the form of prior authorizations, peer reviews, and declined reimbursement payments. You must have made a pretty good deal to be such a powerful presence in the lives of physicians, because I think we are all deeply saddened about the state of our profession. I bring so much work home with me and this carries over into how I am present with my family. But it only seems to bother me, not you. I try to find ways to grow and adapt, but you continue to climb back in and deflate my raft. 

I say these things to make your weight feel lighter, Grief. But I know there is a time for us to be together. There are still days that I learn about a patient who has passed, and you are quick to sit beside me. I ruminate over if I could have done something different to change the outcome. What would one more appointment do for us? Did I fail somehow by not intervening sooner? You remind me to stay humble and to treat each day with care. You remind me of what it feels like to be human. 

Grief, I want you to know that despite confronting you in this way, I know you are needed. You are a universal feeling. Without you, I wouldn’t be considered whole. But the ache I feel is more than I can tolerate anymore. I know that in the darkness, there will eventually be light. I am finally ready to work toward seeing more light and less darkness. Grief, you have a time and a place to be with me, but we need to find a compromise. How can I move through your stages and accept that I want something different? I do accept you for who you are: You are the part of me that I miss, the part of my life that I imagined differently, and that I mourn. You are the imagination of a memory that I want to be different. Yet, you are also the part of me that makes me who I am, in all my forms and feelings. 

Here we are, Grief, at a crossroads. Shall we agree to tolerate each other and allow a time and a place for our meetings? I want to be in control of my destiny and my thoughts, and thus I am limiting our interactions. I know there are times that I cannot control your presence, but I can manage your chatter now. I thank you for showing me how to accept life as it comes, people as they are, and that the highs and the lows are equally as important. I can see you for who you are and thank you for showing up, then we can part ways. I will allow you to be there, Grief, but you are no longer running the show. 

Yours Truly,

Me

Dr. Brittany Panico is a rheumatologist in Phoenix, AZ. She is a wife and mother of three awesome boys and enjoys hiking, being outdoors, traveling, and reading. She posts on @AZRheumDoc on Instagram and Brittany Panico, DO, on LinkedIn. Dr. Panico is a 2023–2024 Doximity Op-Med Fellow.

Illustration by April Brust