A few years ago my husband, then fiancé, gave me the book What Doctors Feel: How Emotions Affect the Practice of Medicine by Danielle Ofri, MD. I had been on this journey to becoming a physician for some time and had received wonderful advice and education from my undergraduate professors and mentors about a career in medicine. However, being the emotional person I am, I was unsettled by the lack of advice regarding dealing with the emotional difficulties of the field. My husband had previously read this book and thought it would help me navigate the next step of my path to becoming a physician and he was definitely right.
There has been a transition with the past few generations of physicians in how emotions are viewed in the practice of medicine. Previously, they were thought to be something that inhibited physicians from providing the best care possible to their patients. Emotions were considered messy and something to be pushed aside so the real work could be done. Recently, though, there has been a shift in thinking and emotions are often viewed as an asset and seen as an investment in the same patients we hope to heal. The newest generations of physicians are being trained to empathize with patients and to really listen. Now, it is believed that the physician-patient relationship is an integral part of the healing process and without which patient care is, at best, limited and at worst, catastrophic.
In her text, What Doctors Feel, Dr. Ofri, a primary care physician, offers refreshing and honest insight into the emotional aspects of both her own life as a physician as well as the lives of many other physicians. She gives an account of a physician who began drinking a glass of wine after work every night to cope with the stress of her job in the Emergency Department and the habit eventually developed into an addiction. Dr. Ofri describes her own experience with both a lawsuit and almost losing a patient because she did not take the patient’s complaints seriously and how both events affected her confidence and her ability to practice medicine. While introducing various problems associated with the neglect of the emotional well being of physicians, Dr. Ofri also offers solutions throughout the text as she cites research and programs that exist to successfully provide support to physicians with the emotional difficulties of a career in medicine.
“In some ways, grief is an aspect of love, a reflection of the ability to connect. As the heart can grow bigger to allow more love, it can also do so for grief. And although I don’t want more grief in my life, I know that the connections that permit grief to occur are the connections that keep us – doctors and patients – alive. “
Interwoven throughout the text is the story of one of her patients, Julia, with whom she had formed a deep connection due to years of treatment. Julia suffered from congestive heart failure and was unable to receive proper health care due to her immigration status. For over a decade, Dr. Ofri had provided care to Julia in hopes that one day she would receive the heart transplant she needed in order to survive. In each section related to Julia’s treatment, Dr. Ofri is raw and honest about how the challenges facing her patient-turned-friend affected her. Eventually, Julia does receive the heart transplant but does not survive weeks past the procedure which leaves Dr. Ofri heartbroken and angry. She recounts visiting Julia for the last time and shares how she said goodbye: listening to her heart at aortic, pulmonic, tricuspid and mitral landmarks and lingering at each position. By taking the reader with her through the experience of caring for this patient, Dr. Ofri explains how she worked through the emotions each step of the way and showed us how to say goodbye to a patient in a way that allows you to still feel like their healer.
“There were times in my training when I envied those doctors, when I wished my armor were stronger. But I also grew to learn that this armor could be destructive, as it does not actually prevent grief from entering; it only channels it into an awkward holding area.”
In our quest to become physicians we are often expected to be superhuman. We are constantly faced with death, disease, grief and sadness in a way that almost no other career is exposed to. And while it is accepted that physicians should be empathic, physicians in training are rarely given the tools to effectively work through the emotions that often prevent them from expressing empathy and compassion towards their patients. I am ever grateful to Dr. Ofri helping me and many other readers realize how okay it is to be emotionally affected by the realities of our field and that we must ensure that we care for ourselves so that we can provide the best care to our patients.
The title of this blog, “What Med Students Feel” is inspired by this text. I see this as a place where I can both discuss the emotional aspects of pursuing a career in medicine and also get away from “that world.” For me writing is a really important, and thankfully healthy, coping mechanism for the hardships associated with both a career in medicine and life in general. It’s a tool I use most often to reflect on and normalize what I’m going through. And as I’ve stated before, this blog is also a place for me to focus on the things outside of medicine that interest me: faith, activism, family, photography, reading, fashion, etc.
It took me a really long time before I realized how okay it is to simply feel the things I feel. Too many years went by before I realized how damaging it can be to neglect what’s actually going on inside you. While this space is primarily for me to retain my own sanity, I hope that it can also help those of you who may often get the feeling that you just feel too much to know that you’re not alone.