Mckenzy Wall ’22 reflects, through personal experience, on the fine line between physicians and their emotional attachment to their patients.
On a humid day mid-June, I entered the infusion center at my local hospital for the first of many times that summer. I was told my job would be to talk to the patients and keep them company. As an aspiring physician, I figured that this would be a good way to dip my foot into the world of oncology. Little did I know how much that day would change my life forever.
With such an open description of what I would be doing as a volunteer, I was unsure of what the experience would entail. I wondered if the patients would even want to talk to me, and more so I found myself growing anxious as I tried to imagine what they would be like. Most of us are familiar with the emotional and physical toll that comes with the diagnosis of cancer, whether it be through a family member or personal experience. It’s the combination of that emotional distress and physical deterioration from progressively more intense treatments that can lead to a loss of hope. So is that what I had expected to find in the infusion center? While I hate to admit it now, I think a part of myself envisioned that to be so. In reality, my expectation could not have been further from the truth.
I walked into a room sparkling with sunshine and filled with smiling nurses hustling about. Fifteen chairs filled with patients lined the left wall and curved around the back of the clinic. I was soon introduced to them one by one, and with each and every introduction I was greeted with a smile from the person in the chair. I never would have guessed that these were people fighting for their lives, unsure of how much time they had left and what their quality of life would be for that time. I left the infusion center that day feeling empowered by the patients’ infectious optimism.
I got to know a few patients really well that summer. I became emotionally attached as they told me all about their lives: their kids, their jobs, the impact of their illness on their lifestyle, and their plan once they overcame it. I realized that if something were to happen to them, I would be absolutely distraught. This prompted me to consider how I would address this in the future as a physician when inevitably every case would not be a success story.
The relationship between patient and physician is delicate. A doctor is told that they mustn’t grow too close to their patients, but it is also expected that they build a relationship where the patient feels comfortable confiding in them. This is a fine line that can be easily crossed in either direction.
Some say a doctor’s work is done best when they separate the illness or ailment completely from the patient. This may inadvertently dehumanize the patient, as they are viewed as their illness and nothing more. While this can indeed be beneficial, for example, on the operating table, it otherwise leads to a lack of trust between physician and patient due to their lacking relationship.
The other side of the spectrum is that one grows too attached. As human beings, we are a social species who innately prefer to form close bonds with those around us. The ability to sympathize and form strong emotions is literally built into our genetic code (Bastiaansen), and therefore it is almost impossible for anyone to complete a task without associating some kind of feeling with it. A doctor’s empathy can sometimes be their greatest weakness.
Those who aspire to be doctors are often the kinds of people who will always put others before themselves, and it is only natural that they find themselves wanting to connect with their patients. It is both a formality and matter of genuine interest when a doctor asks their patients questions about their lives — this not only builds trust but also gives the doctor a better view of the patient’s lifestyle. With every visit, this bond is strengthened. Many of us can relate to this bond, as our primary care physicians who we have visited for years know us inside and out. While a bond like this can likely be maintained when a patient is healthy, things may quickly go south once that is not true. A doctor who is emotionally attached to a patient may go to desperate, and therefore risky, means to save their life such as procedures that may be more beneficial albeit much more difficult to perform or treatments that a patient may not be healthy enough for yet. Doctors can essentially be blinded by their emotions.
This balance of professional and personal relationships between physicians and patients is one that is not easily obtained. While doctors spend years learning every part of the body, observing surgeries, and learning bedside etiquette, virtually nothing can prepare them for the mental toll that their career may take on them. Finding the balance is something doctors may constantly need to search for, and to do so requires the highest level of self awareness and control. As I go forward in my life and my career, the thought of patients I met at the infusion center will always be in the back of my mind. They will serve as a reminder of how wonderful it is to grow close to those I am treating, but they will also serve as a reminder to keep my boundaries in check as to not become too attached. That summer opened my eyes to the delicacy of medicine — of how closely the worlds of pure science and raw emotion tether themselves together to result in a career that is so intricate yet also so rewarding.
Bastiaansen, J. A., Thioux, M., & Keysers, C. (2009). Evidence for mirror systems in emotions. Philosophical transactions of the Royal Society of London. Series B, Biological sciences, 364(1528), 2391-404.