One of the things about being a MD, is that you are expected to have empathy. It is a trait that is drilled into all of us from day 1 of medical school.
Don't misunderstand me, it is a beautiful and admirable quality, but over the years I have realized that it can be couterproductive to be too empathetic. It can actually get into the way of good patient care.
For example...many, many years ago, when I was a young intern, I was assigned to the cardiology service for 3 months. I treated many patients during those months but I remember one particulary well. He was a 50 year old gentleman who was a known diabetic and hypertensive. He was admitted to the cardiiology unit for further investigations because he had been having these recurrent episodes of syncope (fainting), but no one was sure of the cause.
This gentleman was truly a nice person. Many days, after I had finished my ward work, we would sit and chat for hours. He confided in me about his life, work and family among other things, and we became realtively close. I considered him a friend.
In the third week of his admission, he started to have these episodes where immediately after eating, he would have feelings of impending doom, and would become drenched in sweat. The nurses routinely paged me, and we would perform electrocardiograms, cardiac enzymes and various blood investigation, but they would be absolutely normal. This would occur two or three times a day. After a few days of this, he refused to have any further blood test done, and would only want me to sit by his bedside and hold his hand until the sensation passed. This would take anywhere from 45 minutes to 2 hours, but each time I would come to his bedside and hold his hand, until...
One day, I was given the opportunity to see a couple of patients in the cardiology clinic. To me this was a magnificient opportunity and a welcomed change from my mundane ward work which consisted mainly of drawing bloods and organizing various test for the admitted patients. I was happily doing my thing, when just like clockwork, my pager went off at lunch time, and I knew what that meant, my friend was feeling unwell. However, I was in the middle of discussing my clinic patient with the attending (the senior doctor), so I couldn't respond immediately.
And then I heard it over the intercom....code blue in the cardiology unit. I felt my stomach lurch and I dropped everything and just ran. I was unaware that tears were streaming down my face. When I reached his bedside, I saw the critcal care team performing CPR. I just remembered knocking the person doing compressions out of the way and I jumped on his chest. At this point I was sobbing out loud. After some time....I'm not sure how long, one of the senior attendings took me off the patient and escorted me to an empty consultation room. To say I was devastated, would've been an understatement.
I felt as if I had failed my friend. When he needed me the most, I wasn't there. Maybe if I had been there, I would've been able to save him (unlikely... but at the time, that's how I felt). I remember clearly the words of my attending at the debriefing session - "MDSaga, do not get emotionally involved with patients, it makes you ineffective as a physician. At the bedside, you were not helping your patient at all. You were a weeping mess!!'
His words may seem harsh but in hindsite they were 100% true. This was one of my lessons as a young doctor, and it helped pave my way in medicine somewhat. It helped me realize that I did not want to be involved into a field of medicine where I could get attached to my patients.
That's all for now.... MDSaga signing out.
Comments
MDsaga it is a fine line, I imagine. Too much makes you ineffective and too little may mean you don't care enough to try your best for patients