Jeff Kane: Physician, heal thyself
Not long ago I witnessed an encounter between a young woman with a severe autoimmune disorder and her physician, whom I know as an especially caring human being. As the patient cried when describing her pain, I watched the doctor. If I could see the thought balloon over his head, it would have read like this:
“This poor young woman is suffering terribly; I want to get up and just hold her; on the other hand, that’s not very professional.”
He wrung his hands, as though his two sides were struggling with one another. In the end, he resumed a straight face and wrote her a prescription for a more potent painkiller.
Afterward, I asked him how he felt. He said, “Ripped in half.”
That’s a reaction familiar to most docs. Sometimes we want to comfort the patient with a hug or shed our own tear, but feel an almost irresistible pull to act “professional.” We’ve been trained in the notion that patients want a doc who appears not only knowledgeable and confident, but clinically objective, too, so we feel subtly compelled to act unemotional.
Patients differ, of course. Some would prefer that their docs express honest emotions. And others prefer distance. That distance, though, is seldom helpful to most patients, and in addition is tangibly hazardous to doctors.
Virtually wading in people’s suffering daily, we docs can’t help but absorb some of it. As a patient once told me, “Buried emotions are always buried alive.” Imagine, after treating hurting people for decades, how much misery accumulates in us. Yet there’s no mechanism in practice that helps us dispel it. Thus low-grade post-traumatic stress disorder commonly affects docs and other healthcare practitioners. Look up the striking incidence of alcoholism, drug dependence, divorce and suicide among doctors. Charged with enhancing health, their own health statistics ought to be alarming.
Fortunately, they’re curable. Docs don’t need to choose between warmth and a professional posture. I know some who are awesomely competent and as emotionally expressive as anyone else. So when you notice your doc seems distracted or depressed, you might ask, “How are you doing today, doctor? No, really.” Believe me, you’ll be thanked.
Jeff Kane is a physician and writer in Nevada City.
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