Med School Diaries

Disjunction: Emotions in Medicine

I remember hearing about an academic doctor regretting having chosen his specialty and place of practice because it meant being called to resuscitate his professors who suffered heart attack. This was said in light of the death of a doctor, who may have also been his teacher (he teaches medicine in the same university he graduated from), whom he tried to resuscitate.

About a month later, in one of his lectures, while talking about where to auscultate specific heart valves, the same doctor talked about disagreeing with what the deceased professor taught about the anatomical landmarks in the chest. His disclaimer about what he was about to say regarding the landmarks (“Dr. ___ would probably rise from his grave if he hears this…” n.v.) was said so casually – he probably meant it as a joke – it seemed a little insensitive considering how recent the death was and a little strange having come out from the same person who wrote about regretting his chosen specialty.

I remember what Dr. Kalanithi wrote in his book about how casual dissection becomes for the medical student. What initially was a violation of the sacrosanct becomes, in its repetition, a mere exercise of cutting and slicing – the students forgetting that the stiff and lifeless body cut open before them was once a living breathing person with hopes and dreams of his own. And they find themselves feeling guilty not because they were sorry for what they were doing but because they weren’t.

Perhaps it is the same for that doctor. Perhaps years of medical practice do make you jaded towards death… at least to some degree. I don’t think that he did not mean what he had said; he had simply not dwelt on it maybe for a lack of a deep attachment towards the dead doctor or maybe because it is what he has learned to do over the years like the other doctors before him. There is a price to investing too much in patients, I have read. A costly one at that. Doctors are better off learning not to invest too much emotionally lest they become incapacitated by their emotions when things go awry. There is a healthy way of detachment but the line between compassion and indifference is thin and one cannot sit on the fence at all times. Compassion is a deliberate choice to make especially when our tendency for self-preservation inclines towards indifference. After all, if you don’t care, you don’t get hurt.

I don’t really know what made him say what he said. Maybe I am over-analyzing things and misjudging him. If I am, I apologize. I only interpret what I see. But if I am right, I pray that God protect the hearts of not only doctors, but also of medical students, nurses, and every other medical practitioner and may they never harden. May they always value compassion and kindness above all… even at the cost of having to hurt for their patients. May they aim not only to do no harm but to do good and do it all the time.

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