Dr. Jeff Kane: Don’t envy your doctor
A very long time ago, when I was interning in an emergency department, several ambulances arrived from the site of a bombing. They unloaded three victims plus a collection of human fragments. As I placed an endotracheal tube in one patient, the awfulness suddenly hit me: these people had probably been sitting peacefully at home only a half-hour earlier, and now they were a horrifying mass of gore. Overwhelmed, I froze for a moment. Then I thought, “Dude, this is why you’re here. Get back to work.” And I did.
I’m not alone in this experience. All docs have witnessed the unspeakable, but even today there’s hardly any mechanism for processing our own consequent feelings. Subtle echoes from our professional training remind us, “Get back to work. Shake it off, put it behind you, get a grip, toughen up.”
That advice is as harmful as it is useless, since it demands that we repress our emotions. A member of a cancer support group said, “Buried feelings are always buried alive.” Indeed, that’s precisely the source of post-traumatic stress disorder, PTSD.
We usually associate PTSD with soldiers and veterans. Certainly they experience trauma, but there’s plenty of trauma elsewhere, too. Civilians who have been assaulted and abused can suffer it, and it’s not uncommon in medical patients — and even practitioners.
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Imagine being suddenly diagnosed with, say, cancer. Just hearing the C word, your world explodes into confetti. You feel frightened, anxious, lonely and more. If you need immediate care there’s no time to sort these feelings out, though. So you get treated. Months later, you’re finally in remission and you get much of your life back. But friends ask, “What’s with these mood swings? You still feel stressed? Your cancer’s history now, isn’t it?” Well, the cancer may be, but your buried feelings are clawing their way to the surface.
We docs live with a similar threat, since we wade in suffering for a living. We see more than our share of misery, tragedy and horror, and we’ve been taught to deliberately ignore it … and at a substantial cost.
I once facilitated a support group for doctors. Every session was dominated not by the feelings endemic to our work, but by a frantic common insistence that no one outside the group should learn who was in it. For a doctor to admit any vulnerability was taboo.
This is ridiculously ineffectual denial, but I don’t think it’s changed much. Today’s docs complain more than ever about the tribulations of practice and many are depressed and suicidal, but too few take the first step toward treatment, which would be to simply admit that they hurt.
The next time you see your doctor, please ask, “Doc, how are you? No, really.”
Jeff Kane is a physician and writer in Nevada City.
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