Don't become a doctor #6 - Laughing at the pain of others

Recently, my friend West Coast and I were getting a laugh at patient care. He's got a patient who's 400 pounds. We couldn't help but get a few laughs at this patient's expense.

But the thing is, in medicine, we use a lot of dark humor. We laugh a lot at the pain of others, both the patients and our colleagues. The proof in the pudding? Scutmonkey. The author has comics about her horrible med school experiences, and me and WC were falling out of our chairs laughing at it.

In med school, one med student, Handwriting, he was an idiot, but everyone loved him because of his amazing handwriting. One day, we were having a bioethics discussion about delivering bad news, and our prof mentioned that a lot of times we'll use euphemisms for death in the hospital. "Like celestial discharge?" one med student chimed in. Instantly, we were coming up with a ton of such euphemisms: transfer to the pathology service, basement admission (the morgue is usually in the basement), organ donor (motorcyclists who don't wear helmets), ICU cuisine (tube feeding), M&M rounds (my rounds on vascular surgery, where patients died like flies).

Handwriting, he was appalled. His gut reaction: "Well, we shouldn't make fun of these situations. It's wrong." We were all silent, not shamed but outraged. How can we NOT make fun of this? What's the alternative? Go home and cry our eyes out every day?

I had another med school colleague who did just that. I'd see her in the hospital when she was off service, but she was visiting her patients, sometimes for weeks. At first, I thought it was noble to be so attached to her patients. Then I realized that there was no way I could do it. It was like self-inflicted torture.

There was a nice episode of Scrubs that I really liked, and I'm sure I've quoted it before, but the episode was about how they were making fun of the patients in the hospital, and Dr. Cox had this to say:

Lemme guess, you're off to another funeral. ... Turn around. Turn around. You see Dr. Wen in there? He's explaining to that family that something went wrong and that the patient died. He's gonna tell them what happened, he's gonna say he's sorry and then he's going back to work. Do you think anybody else in that room is going back to work today? That is why we distance ourselves, that is why we make jokes. We don't do it because it's fun, we do it so we can get by and sometimes because it's fun. But mostly its the gettin' by thing.

If you find yourself like Handwriting, offended at the thought of laughing at the pain of others, you'd best avoid medicine entirely.


Simon said...

I can swear that that quote, word for word, was used in a House M.D. episode I saw in re-runs last week...

Shabine said...

It's a very good quote...

Anonymous said...

You can let medicine get the best of you, or you can decide not to let that happen.

"At first, I thought it was noble to be so attached to her patients. Then I realized that there was no way I could do it."

You are correct, you can't do it. Whether you can create and sustain that attachment to your patients is your own personal choice, and clearly you have failed at that in your career. You should be ashamed you call yourself doctor.

incidental findings said...

Y'know, I wrote a very polite rebuttal to the above, but what's the point. It's not like it'll change anyone's mind. Let people think what they want to think. The only opinions I care about are my patients'.