In this narrative medicine essay, a neurosurgeon shares his experience coping with a career-ending elbow injury, exploring grief, resilience, and the journey to finding new purpose.
- Source: JAMA, Published online March 16, 2023
- Author: Joseph D. Stern, MD
Experiencing the Loss of a Career #
Lying awake, I stretch my arm as if performing surgery, only to feel sharp pain. Simple tasks—like removing my trouser leg—become frustrating challenges. This injury forced me to confront what my friend Gus described as “like a death.” Unlike Gus, who retired on his own terms, I was forced to stop surgery due to intractable elbow pain.
For three years, I endured intermittent pain, taking short breaks that temporarily relieved symptoms. But this time, nothing helped. Even with a partner assisting during surgeries, my limitations remained, leading me to withdraw completely from my surgical practice. A month later, I underwent surgery on my own arm.
Relearning Daily Activities and Facing Disability #
I am now relearning basic movements I once took for granted: straightening my arm, making a fist, grasping, and pulling. My physical therapist and surgeon help me adapt, but the gap between past and present capabilities feels vast.
Suddenly, I am on the other side of the patient experience. Like my neighbor Ron, a former pediatrician who suffered a stroke, I now confront the limitations that illness and injury impose. Daily life slows, routines shift, and dependence on others becomes unavoidable.
The Emotional Impact of Career-Ending Injury #
Leaving a career you love prematurely feels like a form of death. The nurse who supported me for 15 years found a new position, my patients were reassigned, and soon my office will be cleared. Though I am alive, the death of my previous professional identity feels complete.
As a neurosurgeon, I was always surrounded by illness and death but never personally affected—until now. Observing my patients’ struggles, I recognized the profound loss of identity and purpose that accompanies a disabling injury. Experiencing this firsthand gave me new insight into the emotional toll of becoming a patient.
Coping with Grief and Loss #
When my younger sister died of leukemia, I understood the inevitability of becoming a patient. Disability can strike unexpectedly, often reshaping reality in disorienting ways. Pain, loss of function, and interrupted sleep demand a resetting of goals. Small victories, like bending fingers or making a fist, become milestones. Support from others and recognition of shared suffering are crucial for emotional resilience.
Finding Meaning and Resilience #
One partner’s advice resonates: “It could always suck worse.” This perspective encourages focusing on retained capabilities rather than dwelling on loss. Witnessing my patients’ bravery in recovery inspires me to celebrate small achievements and cultivate gratitude instead of bitterness.
While my father-in-law’s death underscored the finality of mortality, my injury represents a new beginning—a fork in the road requiring adaptation and hope. Though I have lost some abilities, I am committed to recovery and discovering a new sense of purpose.
Lessons from Disability and Recovery #
- Accept Limitations – Recognize what you can and cannot do.
- Celebrate Small Victories – Even minor improvements are meaningful.
- Seek Support – Physical therapists, surgeons, and peers provide guidance and encouragement.
- Maintain Perspective – Compare setbacks with potential for future improvement.
- Find New Purpose – Redefine personal and professional goals in light of current capabilities.
Conclusion: From Loss to Hope #
Although career-ending injury can feel like a death, it is also an opportunity for resilience, adaptation, and renewed purpose. By embracing what remains possible, seeking support, and celebrating small milestones, one can navigate grief and emerge with a deeper understanding of life’s fragility and potential for growth.