Tuesday, March 20, 2007


No matter how close I get to my patients, I realize that I was never really that close.

And there's no better confirmation of this fact than standing by their bedside at their time of death. While the patient's family is grieving, I'm just standing there emotionless.

Perhaps this may change as I continue to practice medicine and develop more long term relationships with my patients. Maybe I'm just not that emotionally available to my patients as I think I am, but I've found out that losing a patient isn't as devastating as they show on TV or movies. And I'm ashamed to say, I was more devastated when the dog I grew up with died while I was at college.

Could also be that I've become just cold hearted over the years.

It's not that watching your patient die is an easy thing to go through. A nauseatingly empty, gnawing feeling develops in the pit of the stomach. Nevermind the sense of failure, or the feelings of inadequacy, or even the weight of responsibility wrecking havoc through your inner core exacerbated by the ever present knowledge of living in a litigious-happy society. But I've never broken down and cried, or drowned myself in alcohol, or became completely non-functional and had to go home. Unlike what's often portrayed on TV, I've never found myself reduced to a blubbering mess after losing a patient. And it's not because I'm some super-human, or that I've just got my shit together, or that I'm capable of completely controlling my emotions.

It's because I've got a number of other patients that are under my care. I can't just quit and go home for the day because one died.

After a patient dies, I spend time to grieve with the family, answer their questions, and do my best to help them find some kind of closure. But then I go back to work. I've got other patients that need me.

I guess I subconsciously build emotional walls to keep patients out. It's a necessary part of my job. And it has to be done so that I can think rationally and do what's best for the patient without having to counter rash actions motivated by emotional ties. It's done so that every one of my patients will receive the same amount of care and dedication. And most importantly, the correct treatment unspoiled by emotional interference.

That's why most physicians try not to care for their own family members. It's just too easy to let your heart and emotions rush you into illogical, irrational, and dangerous treatment plans: Hail Marys, last ditch efforts, heroic measures, all mixed in with a generous dose of self doubt. Logical and methodical judgement clouded over by emotional surges.

You would think that having a family member be your physician would be a great idea. But there's too much of a risk. It's just not worth it.