“What Doctors Feel” Matters, Says Dr. Danielle Ofri

From Dr. Danielle Ofri’s What Doctors Feel

Medical students, for all of their competence and competitiveness, are a pretty fearful bunch, more so than the general population and even more than their age-matched peers pursuing other professions. Some of this is not surprising. You really should possess some fear as you begin to jab sharp objects into other people’s bodies, prescribe potentially lethal medicines, or initiate treatments that put lives at risk. Any medical student without fear is a cavalier cowboy better suited to a desk job.
But the fears can easily spiral out of control and overwhelm students and interns. If this happened only rarely, to only those few who entered the medical field with their own preexisting mental-health conditions, that would be one thing. But the truth is that the fear overwhelms even the most psychologically sound and well-adjusted trainee. At some point it happens to nearly every single person who travels through the medical training process. If you don’t believe me, just ask any doctor you know. 

Fear and sheer terror. Also: Sadness and sorrow…Empathy…Anger, grief, despair…Shame, disillusionment…Hope, love, joy…Pride, gratitude, humility. In What Doctors Feel: How Emotions Affect the Practice of Medicine hospital-based internist Dr. Danielle Ofri admits all of these types of feelings are experienced regularly by her and others in the medical profession.

How would most patients know that? They wouldn’t. Thus, we need somebody like Ofri to tell us. Last year she wrote in The New York Times:

By now, even the most hard-core, old-school doctors recognize that emotions are present in medicine at every level, but the consideration of them rarely makes it into medical school curriculums, let alone professional charters. Typically, feelings are lumped into the catch-all of stress or fatigue, with the unspoken assumption that with enough gumption these irritants can be corralled.

The emotional layers in medicine, however, are far more pervasive…Emotions can overshadow clinical algorithms, quality control measures, even medical experience. We may never fully master them, but we must at least be conscious of them and of how they can sometimes dominate the symphony of our actions.

It’s not that most doctors can’t do their jobs because they have emotions, it’s that doctors need to recognize they have them and not let certain ones affect the care they provide.

Ofri reports research on empathy, for example, showing that it steadily declines in doctors as early as medical school. A depressing thought, but an understandable side effect of dealing continually with difficult, often life-threatening, dilemmas. Gradually, the students’ (and later full-fledged doctors’) consequent suppression of feelings blunts their ability to empathize.

According to the publisher of What Doctors Feel, Ofri offers stories about herself and other doctors that illustrate the kinds of issues they face:

She admits to the humiliation of an error that nearly killed one of her patients and her forever fear of making another. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. But doctors don’t only feel fear, grief, and frustration. Ofri also reveals that doctors tell bad jokes about ‘toxic sock syndrome,’ cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.

Publishers Weekly: “Ofri’s passionate examination of her own fears and doubts alongside broader concerns within the medical field should be eye-opening for the public—and required reading for medical students.”

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