Thursday, September 07, 2006

Bedside manner

Last night as I was working in the emergency department I was talking with one of the other residents who told me the story of his nephew who is dying with ependimoma. He told me how he had been through intensive radiation therapy for six weeks that involved therapy every single day during that time. The cancer was in remission for a year or so until that fateful MRI when the cancer was seen to have spread all over the brain and spinal cord. Now it's a matter of just a few months. He said that his nephew's family were able to take him to Disneyworld with the Make a Wish program and he was tucked in at night by a different Disney character each night.

His nephew is three years old. He was two when he was originally diagnosed. Just my Sam's age.

As he told me the story I got pretty emotional imagining my perfect son dying through a horrible long term illness (or even overnight in a terrible accident). The thought is devastating in a way that no other thought is.

Then I imagined myself next year as the physician directing the radiation therapy for this little boy. What would I do and how should I act? Would I allow myself to show my emotions and have a good cry with the family or should I be sympathetic but detached in hopes of allowing the family their grief but keeping the credibility perceived in a non-emotional assessment of the therapy's progress? I never had the experience of being involved in therapy quite like this during my oncology fellowship or my rotation last year. It will be interesting to see what it ends up being like.

7 comments:

Shana said...

I think I'd rather have a doctor that cries with me. I don't think there's anything about being sympathetic and sharing someone else's pain that makes a person any less professional. No matter what--it sounds like your job will be very difficult at times and very rewarding at others. Hope it's more rewarding than difficult.

Ree said...

Why is there that perception that a doctor must be non-emotional in order to be credible? I agree with Shana. A doctor who showed his humanity and felt my pain would hardly loose respect and credibility in my book.

Tarimisu said...

You ladies echoed my thoughts. The times my kids have been in the hospital, it was the doctors that showed kindness and a connection with human emotions and humanity itself that gained my respect. I felt that they were really concerned for my children and for me as a parent. I say, go ahead and cry with them.

Taffy said...

As long as you are not bawling so heard that you can't communicate important information to the family and/or patient, I see no problem with showing emotion. Crying with their pain shows that you care.

B said...

Amen, Sistas! Go ahead and show your emotion...I think you all would be better for it.

Ben said...

Whenever I hear about horrible things happening to small children--in my case it's usually kidnappings and the like rather than medical problems--I always picture my daughter in that situation and have to keep myself from dropping to the floor and sobbing. There are a lot of other reasons I could not be a doctor as well, among them the fact that I get light-headed at the thought of blood, but an inability to keep from getting too emotionally involved is definitely one of them.

I agree that it should be okay for doctors to express emotion, but I think part of the reason we have that social norm of doctors maintaining a professional distance is to protect the doctors themselves--how else can you deal with sick and dying people on a daily basis (admittedly I'm generalizing the whole medical profession here) and still live a happy, normal life?

Ben said...

PS Blame Google Reader for the fact that I'm commenting on a month-old post.