Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

As a doctor, I need to understand power, trust, and pain

Cia Bishop, MD
Education
March 31, 2015
Share
Tweet
Share

“You have the nurse hand you the equipment, that way she doesn’t just stand and stare like a chaperone,” my doctoring mentor explained to me before we entered the room to do a pap smear on a young, 35-year-old woman. My doctoring mentor is a middle-aged, 6-foot-5, exceptionally hairy, broad-shouldered man that carries a warm, jovial presence. Yet the reality of the fallen world is that no matter how sweet, happily married, and professional he is — there is an underlying assumption of potential misconduct lying in the room.

“You always let the patient undress themselves — it helps preserve any sense of possible dignity.” With the pap smears, he always lets the woman lift up her gown and/or take off her undergarments themselves, helping only if she’s physically limited to do so. Same with rectal exams: “Always let the man drop his drawers himself.”

“And you want to touch their inner thigh with the back of your gloved hand before the actual speculum exam; it’s a simple gesture to help prepare them, even help relax them, for what’s next.”

They’re simple acts, but all crucial, in building trust during these intimate interactions with patients. It’s a trust that affirms this procedure is normal in a physician’s office, and a trust that asserts what’s being done is for the patient’s overall good.

As I start learning the physical exam, I find myself often apologizing and fumbling over my cold hands. Whether they graze a woman’s breast when taking blood pressure or take too long with an otoscope in a child’s ear, I’m slowly learning my touch is allowed. My hands are meant to poke and prod, rub and press, comfort and care. People — sometimes patients, other times friends, and even strangers — will come to trust my hands. As cold and as small as they are, I’m allowed to do this. This is what they’re meant to do.

Crossing “normal” physical boundaries are only one dimension of the patient-physician interaction. Coupled with that is the steep emotional vulnerability of an honest patient. In 10 minutes, a patient can divulge to me everything from their sexual habits to their bowel patterns to the death of a parent or sibling. I’ll ask them about their happiness, their genital warts, their marriages, their nail-biting. My white coat gives me an express, all-access pass to people’s stories and secrets. This is a pass that comes with responsibilities and expectations, privilege and power.

As I hear more stories and listen to more secrets through my community mentor site, I find myself already being numbed to pain — another mother with a miscarriage, another demented grandfather, another suicidal teen. Interestingly, I realize I have a hint of self-assurance with it. I can handle it. I can compartmentalize. I’m getting better at this. Yet I wonder if these emotional barricades are they way I want to always practice. Without a doubt, they will be needed for my personal sanity and self-care, for I can’t go home still thinking and crying about all my patients. However, in the confines of a doctor’s office, I wonder if my emotions do need to be completely hidden. In all honestly, I believe it’s OK for a doctor to take empathy to another level: to cry with a patient, to share one’s own experiences with illness, to even pray with them if desired. Yes, doctors are hopefully the problem-solvers in the situation; however, that doesn’t mean they can’t sit with you in the pain of the problem itself.

I’m repeatedly realizing my biology textbooks can only get me so far. The role of a physician isn’t limited to physiology and pathology. I believe as a doctor, I also need to understand power, trust, and pain. There’s a lot power in my gloved hands; my white coat is a visual symbol of “trust me,” and a patient’s pain is why we’re talking right now.  If I don’t appreciate and acknowledge these, I’ll abuse my power, I won’t build trust, and I’ll ultimately forget why I’m helping you — why I’ve chosen this career.

So whether it be touching the inner thigh before a pap smear or crying with a grieving mother, I’m okay with that. I will do that. I want my patients to trust me. And not merely because I’m a doctor, but to trust me because I’m also simply another human who gets how uncomfortable this nakedness and question-answer sessions are.

Cia Mathew is a medical student.

Prev

Is there a role for doctors in the brave new health care world?

March 31, 2015 Kevin 16
…
Next

Hospitalists: It's time to be more exclusive

March 31, 2015 Kevin 2
…

Tagged as: Medical school

Post navigation

< Previous Post
Is there a role for doctors in the brave new health care world?
Next Post >
Hospitalists: It's time to be more exclusive

ADVERTISEMENT

More by Cia Bishop, MD

  • How privileged a physician’s knowledge is

    Cia Bishop, MD
  • A fetal complication is an extension of a mother

    Cia Bishop, MD

More in Education

  • How I learned to stop worrying and love AI

    Rajeev Dutta
  • Why medical student debt is killing primary care in America

    Alexander Camp
  • Why the pre-med path is pushing future doctors to the brink

    Jordan Williamson, MEd
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: Why the NRMP’s SOAP process is broken

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

As a doctor, I need to understand power, trust, and pain
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...