Does being a doctor make me less human? (Published in BMA News 21st March 2014)

The first time a young patient, that is under the age of 50, I was looking after died, I cried. He was a perpetually cheerful chap with diabetes, who developed an abscess that just kept spreading and spreading despite numerous trips to theatre. He put up with my many attempts and cannulation and venepuncture cheerfully. I paid my last trip to see him in ITU, before he was taken to the morgue and cried.

About a year later my wife was giving birth to our first child and things were happening quickly. By the time we got to the hospital she was ready to push and my emotions were all over the place. At one point I started to cry, because there was nothing I could do about the pain she was in.

She turned and looked at me and said very firmly, “Don’t you fall to pieces as well. I need you not to cry for me.”

So I didn’t. I found this ability to switch off my emotions, an ability that I had probably been cultivating over the previous year or so as a junior doctor. An ability to distance myself emotionally from distressing situations where there was nothing I could to alleviate someone else’s pain; emotional, physical or psychological.

Years on, I wonder now if I have developed the ability to be less human. If non-doctors had to hear the heartache stories that I do, could they maintain a dry eye, a dry heart. I tell myself that I am acting in a thoroughly professional and detached way and that emotional involvement with patients’ suffering will have a detrimental effect on me. But I wonder if I can remember how to switch those emotions back on, when I am supposed to. For example, at a recent family funeral everyone complimented me on how well I did the reading – clearly and calmly, perhaps drawing on hint of professionalism.

And now as I say goodbye to patients I have known, that die, before signing forms to say they are safe to be cremated, I don’t shed a tear. Not even as I embrace their relatives and offer condolences. The shutters are well and truly down. If I am to provide compassionate care, which is my hope, then perhaps I need to let the cracks show a bit more. Can I be compassionate, without passion, without emotions? I’m hoping that by being more human with my patients and their families I can avoid slipping into all-to-easy trap of being “professional” with my own friends and family.

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2 thoughts on “Does being a doctor make me less human? (Published in BMA News 21st March 2014)

  1. Fabulous piece.

    We need to be able to connect with people and the populations that we serve. Without “kinship” there can be no kindness.

    To sustain a career in the NHS we need intellectual curiosity about people, their contexts, their illnesses: to ask questions like “why is the patient here?” “Why now?” “What is really going on?” “what does the evidence say might help?”

    We also need resilience, including the ability to balance the needs of the individual against the needs of many, the ability to learn to be optimistic in difficult situations, to be able to do what Steven Covey calls “sharpening the saw”.

    These three things: resilience, curiosity and kinship hold our professionalism, indeed our very humanity.

    I don’t know if you have read “Some Lives” by David Widgery? It describes a young optimistic doctor trying to make a difference in the East End of London in Thatcher’s Britain at a time of economic decay. David witnesses suffering that changes him. Sometimes he admits that he wishes he did not know the depth of human misery that could make him feel powerless. Sometimes his response to the suffering felt inadequate next to apparent political indifference in wider society. It ground him down.

    Witness changes us and it has changed you. But your wife is right: we can’t fall to pieces, you are needed to be strong. Your “switch” is an important part of your resilience. It is valuable. As long as it doesn’t stop you connecting/showing kinship and allows you to remain intellectually curious….I suspect your switch will serve you well.

    Like

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