Doctors Taking Care Of Their Own Psychological Lives

Clabby JF. The physician as warrior (eletter).

http://www.annfammed.org/cgi/eletters/2/2/175#1627,17 March 2005, Annals of Family Medicine.  Response to “Getting the News”   Roger A. Rosenblatt MD, MPH, Annals of Family Medicine, Vol. 2, No. 2, March/April 2004

The Physician as Warrior  

     We like having warriors in our professions.  Dr. Roger Rosenblatt describes a number of physician warriors in his evocative essay.  A series of physicians, even those who are good friends of his, tell him about his prostate cancer in most impersonal and detached styles. But we count on our health care providers to be tough, don’t we? We want our doctors to cancel their plans to exercise or see their children play soccer so they can take care of our acute medical needs. We want our doctors to stay up late with expectant mothers and still be alert and skilled enough to provide good care.  To do this, warriors have to “cover-over” some of their emotional reactions to their  patients’ suffering.  They have to emotionally distance themselves from their own heartaches and the emotional wounds of those around them  in order to complete complex procedures for us.

The training begins early.  Parents, teachers, coaches of children and adolescents seem to be in agreement about this. “Don’t be a baby, you can handle it”, or “Get back on the field, it’s just a bruise.”  We continue this socialization in college, medical school, and residency training.   Attending physicians understand the need for warrior physicians as they remind their young residents to toughen up, recalling how much rougher residency training was before these “new rules” came into being.

Developing warriors does come at a price. Because warriors steel themselves from fully  noticing the suffering around them, they may remain particularly unwise to the lessons that can be learned. Warriors tend to wait until tragic or near tragic life events happen before they make changes to improve their own health and well-being. Perhaps it is just a part of the human condition.

Dr. Rosenblatt, like many of us who have had scares in our lives, tells us that he will make life changes. With hard-won wisdom, he writes that he is planning to spend more time with his family. No longer will he form short-sighted judgments about people like he used to.  He realizes that he “lives in the same shadow of mortality that falls on everyone”.

We can help warrior physicians find survivable ways to let in a little more of the pain of the emotional pain of their patients. Physicians would be less stuck in providing “routinized” statements of empathy.  They would have more mutually healing connections with their patients.  In allowing themselves to be more affectively impacted by others’ suffering, warriors can still be tough but could benefit from the lessons of those smaller battles.  They may not have to wait for personally life-threatening experiences to provide the wisdom they need to make healthy life changes for themselves, their patients, and their families.  We have to take better care of the warrior physicians who take such good care of us.