Every now and then...

I think one of the things that I feared the most about being a doctor was crying. I was very afraid that my patients would cry. I myself am a pretty emotional guy, and I would probably cry too, so I was eager to keep an emotional distance. But one attending I worked with bucked that notion. Why shouldn't I cry? Am I made of stone? Compassion is a noble thing, not to be hidden or suppressed.

And since then, I have tried to be compassionate to the emotional wellbeing of my patients. Call it biopsychosocial if you like. I try to make sure my patients know that it is my job to care for them, not their disease. And most of the time, this is okay, but every now and then, it can be tough.

I had one patient, a very nice lady with fibromyalgia and IBS. I know the data as well as anyone else. Chances are she has a background of abuse or other psychological trauma. But I'm patient and I wait for her to feel comfortable with me. After several months, it comes out one afternoon. She had recently been mugged, and it gave her flashbacks to when she was a little girl, and she was physically and sexually abused by her father. I don't know about you, but it's hard to sit in a room with a woman who is telling you her deepest secrets of being abused and raped and not shed a tear.

We sat in the office crying, both of us, and it was tough, but every now and then, it is good to be reminded that there is more to patient care than titration of meds and diagnostic testing: that seeing her that day and letting her share the deepest secret of her life probably did her more good than all the meds I'd written.