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

The price of being a compassionate doctor is often worth it

Kevin Tolliver, MD, MBA
Physician
September 10, 2018
Share
Tweet
Share

Watching patients suffer and die is not an easy thing to do. Left unchecked, I don’t think most front-line doctors would last too long immersed in that kind of setting.  First, the emotional toll would be too high to maintain over a long period of time. Second, working at the extremes of emotion doesn’t allow a physician to competently and objectively apply medical knowledge to heal disease and alleviate suffering. Not convinced? Imagine you get terrible news about something or someone, or are as angry as you could possibly be. Now, while still feeling that way, go take a high-stakes exam or give a presentation to a large audience. It would be tough, if not impossible, to do, right? If you could get through it, I’m certain it wouldn’t be your best work. Well, this emotional effect can hinder doctors too if we’re not careful.

In late medical school and residency training, for the sake of emotional self-preservation, doctors are forced to learn through firsthand experience, and by watching their mentors, how to emotionally detach just enough to remain effective. In fact, this lesson in medicine is so important that it has been written about. In an incredibly popular book called House of God, the author takes a satirical and comedic look at intern year of medical training and outlines hospital rule #4: “The patient is the one with the disease.”  Now, the author’s intent wasn’t to be insensitive toward patients at all, but instead to convey a serious message to aspiring doctors. To survive working amid suffering and dying, the doctor must make a conscious effort not to fully enter the suffering of every patient. Please understand, however, there is certainly a balance to this approach. The goal is for the physician to remain compassionate and caring, not a cold, robotic healer in a white coat.

Having said all that, I’m going to tell you this approach doesn’t always work. Since physicians are constantly working close to the fire, it’s only natural we occasionally get burned. I started medical training in 2001, and I admit I’m now mostly accustomed to taking care of horrible diseases and sad cases, but sometimes it is just too difficult not to enter the full suffering of the patient.  These are typically the cases that remind me of a loved one or are so unspeakably tragic that no coping mechanism is going to work.

I have cared for many of these cases over the years, some of which I still carry with me to this day. I can recall details of each case like it was just yesterday, and probably always will. They help remind me that doctors ultimately treat people, not diseases. We don’t work in an emotional vacuum. In fact, the most recent case that was just plain terrible was a couple of weeks ago. A female in her early 20s had been having back pain for the last six months. It started off rather innocently, and she didn’t think too much about it. After all, she was pregnant and just assumed it was related somehow. Unfortunately, the pain worsened, even after she gave birth to a healthy son. She finally came in when she was no longer able to walk. Her son is two months old now.

A CT scan revealed an enormous mass originating from her left hip and pushing on the nerves coming from her spinal cord. A biopsy confirmed our fears — it was a form of bone cancer.  She started on chemotherapy and was released to home on pain medication, but her life will never be the same. Her cancer won’t be curable, and she very likely won’t survive to see her new son start kindergarten. To be honest, maybe not even his first birthday. How tragic! Perhaps it’s because I have young children too, but there was no detaching from this case. I felt the weight of her diagnosis as much as someone looking in from the outside possibly could. I’ve been thinking about her often since she left the hospital. I wonder how she is doing now?

Cases like this are not infrequent for many physicians. They serve as a potent reminder to make sure those you love know exactly how you feel, and not to take your time for granted. You shouldn’t live in fear, of course, but none of us are guaranteed anything.

It’s nearly impossible for a genuinely compassionate doctor not to leave small pieces of themselves behind along the way. But, to be honest, I wouldn’t have it any other way. That’s the way medicine is supposed to work.

Kevin Tolliver is an internal medicine physician who blogs at My Medical Musings.

Image credit: Shutterstock.com

Prev

The foundation of medicine is love

September 10, 2018 Kevin 6
…
Next

3 ways we’ve failed woman who breastfeed

September 10, 2018 Kevin 4
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
The foundation of medicine is love
Next Post >
3 ways we’ve failed woman who breastfeed

ADVERTISEMENT

More by Kevin Tolliver, MD, MBA

  • The nuances between palliative care vs. physician-assisted suicide

    Kevin Tolliver, MD, MBA
  • A framework to understand universal health care

    Kevin Tolliver, MD, MBA
  • 10 surprising things you need to know about the hospital

    Kevin Tolliver, MD, MBA

Related Posts

  • Want to find the best doctor? Don’t rely on price tags.

    Michael L. Millenson
  • Osler and the doctor-patient relationship

    Leonard Wang
  • Finding a new doctor is like dating

    R. Lynn Barnett
  • Are generic drug price hikes media hype?

    Peter Ubel, MD
  • Doctor, how are you, really?

    Deborah Courtney
  • A physician’s addiction to social media

    Amanda Xi, MD

More in Physician

  • Why Canada is losing its skilled immigrant doctors

    Olumuyiwa Bamgbade, MD
  • Why doctors are reclaiming control from burnout culture

    Maureen Gibbons, MD
  • Why screening for diseases you might have can backfire

    Andy Lazris, MD and Alan Roth, DO
  • Why “do no harm” might be harming modern medicine

    Sabooh S. Mubbashar, MD
  • International doctors blocked by visa delays as U.S. faces physician shortage

    Arthur Lazarus, MD, MBA
  • How I redesigned my life as a physician without abandoning medicine

    Ben Reinking, MD
  • 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
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • 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

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

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

Leave a Comment

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
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • How to speak the language of leadership to improve doctor wellness [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • 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

    • Why Canada is losing its skilled immigrant doctors

      Olumuyiwa Bamgbade, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • Would The Pitts’ Dr. Robby Robinavitch welcome a new colleague? Yes. Especially if their initials were AI.

      Gabe Jones, MBA | Tech
    • Why medicine must stop worshipping burnout and start valuing humanity

      Sarah White, APRN | Conditions
    • Why screening for diseases you might have can backfire

      Andy Lazris, MD and Alan Roth, DO | Physician
    • How organizational culture drives top talent away [PODCAST]

      The Podcast by KevinMD | Podcast

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

Leave a Comment

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

Loading Comments...