Tuesday, March 27, 2007

Dropping Detachment and Reconnecting to Patients

Dropping Detachment and Reconnecting to Patients - New York Times:

Abigail Zuger discusses two works on the physician-patient relationship and the expeience of illness in today's Science Times:
At some point during training, medical students often unconsciously begin to think of their patients as alien beings, members of a weak, unlucky species of unrelated biped. It is a predictable, if regrettable, psychic defense mechanism in those first difficult years of immersion in human disability and death.

Fortunately, at some point in the decades after medical school, doctors often realize that they and their patients belong to the same species of unlucky biped, after all (beware the doctor who never figures this out). Sometimes it is an illness of the doctor’s own that does it or illness in the family or just a slow unclenching of the mind.

But once that epiphany dawns, doctors are never the same again; they look back on their harsh and distanced younger selves with disbelief and, if they are of an analytical bent, try to figure out what happened.

Two new midlife memoirs retrace this cycle of estrangement and reconnection.

I occasionally am able to break into our Med School curriculum to offer an elective on Caring for the Dying Patient. Somehow that is not high on our list of teaching priorities for future doctors. The following passage from Zuger's review particularly caught my eye:
Dr. [Pauline] Chen also provides some competent (and fully referenced) academic discussions on how the medical profession stumbles in teaching empathy to students, but the real power of her book lies in her stories. Balanced and perfect, each one seeks out the reader’s heart like a guided missile, and explodes.