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The Pediatrician and the Dying Child

"Physician, Know Thyself"

U.S.C. School of Medicine, Department of Pediatrics, 1934 Hospital Place, Los Angeles, Calif. 90033

Darleen Powars

U.S.C. School of Medicine, Director Pediatric Hematology-Oncology

To deal with problems aroused in professional medical staff working with fatally ill children, a team of psychiatrists and oncologists not only deals with the problems of the children and their families, but also with problems of the medical staff themselves. Psychotherapy to the medical staff is offered only indirectly. The overriding difficulty which prevents the medical staff from maintaining role-appropriate be havior is dealing with the theme of death. Often this is the hidden agenda behind a facade of other presenting problems. At times, the medical staff may be unable to deal with their own anger when confronted by demanding patients or hostile parents. At other times, medical staff will overidentify with the patient resulting in inap propriate role behavior. When medical results are poor despite good medical care, staff may feel inappropriately guilty. These issues can be dealt with by means of a weekly mental health conference with the focus on the patient.

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