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Human emotions run rampant in the
hospital.
Doctors give earth-shattering news to those
full of life. Life slowly leaves these patients. Organ systems begin to shut
down, the patient alternates between awareness and unconsciousness, and
machines begin to take over vital functions such as keeping the heart beating
and the lungs expanding. Doctors also provide life-saving treatment. Life comes
back. It steadily turns a patient’s skin from gray to pink, revitalizes the
soul, and lets the lungs expand and the heart beat on its own.
Joy. Anguish. Thankfulness. Frustration.
Anger. Despair. Hope.
As healthcare providers, we experience
these emotions too. It is natural to cry at death. It is natural to feel
jubilant when our modern medicine heals a patient fully. But, we often suppress
these emotions with the hopes of bettering patient care and protecting our
mental health. As a medical student, I am often told by superiors to not get
“too involved” with a patient and to “never bring my emotions home.” Emotions
can impede patient care by causing physicians to abandon science and evidence. However,
I believe that emotions in medicine can serve two main purposes. The first
purpose is that the recognition and display of personal emotions helps us heal
ourselves. I learned this lesson from Timmy. The second purpose is that
emotions can help us connect to patients and bring back the human aspects of
medicine even in a hospital full of check lists, following algorithms, and running
test after test on our patients. This, I learned from Julie.
I met Timmy on my third year rotation
through pediatric oncology. I was sitting in a conference room with Timmy, his
mother and father, and a pediatric oncologist. Timmy, a 17-year-old boy, had
short curly brown hair and a contagious smile. He was a junior in high school
with plans to attend college and work in the healthcare field.
Timmy had been diagnosed with osteosarcoma
at a young age. While he should have spent his childhood playing and developing his imagination,
he had spent months on chemotherapy and a significant amount of time in the
hospital. His cancer went into remission and his family thought he had won the
fight against cancer. Today, we were here to tell him that his cancer was back.
It had metastasized to his lungs. As the oncologist gave the news to Timmy and
his parents, his mom started sobbing. His dad looked stone-faced at the bare,
white wall. Timmy looked at his lap, his legs shaking.
That night, I went to the library and did
what I knew how to do best. I grabbed a book and opened my computer. I immersed
myself in the textbooks and medical literature on the topic of osteosarcoma. I
learned about its effects on the body, the treatment, the risk of recurrence
and the prognosis of metastatic disease. I looked at the clock after I thought
one hour had passed. It was five hours later.
I still felt empty.
I realized that until I explored my
physical and emotional well being, I would continue to feel empty. Physically,
I had uneasiness in my stomach and a throbbing in my head. Emotionally, I was
angry. I was angry that this happened to such a sweet kid. I felt despair.
Despair at the prognosis and of the cancer growing in his body. I decided it
was needed to explore these emotions. I wrote about my emotions and I talked
through these emotions with close friends. In this case, I did not suppress my
emotions. I uncovered them. I felt better. I had used my emotions to help heal
myself.
Julie, whom I met during my surgery
rotation, taught me another important lesson about emotions. I walked into
Julie’s room to obtain more information that our team needed for her treatment,
and I was greeted by multiple voices. Julie, a 76-year-old female, had an
entourage of visitors consisting of a daughter and three grandchildren. I
offered to come back, but Julie told me to just wait a moment because everyone
was leaving.
Julie arms reached out first to her three
young grandchildren. The three children, all with bright blond hair, jumped on
the bed to give their grandmother a hug. The six year old, gave her grandmother
a bear-hug and said, “Grandma, I love you… even more than the cookies you make!”
The three grandchildren giggled uncontrollably. Julie then proceeded to hug and
say good-bye to her daughter. Everyone left.
Thoughts raced through my head as they
were leaving. I just witnessed Julie as an adored mother and grandmother. At
the same time, I knew Julie had pancreatic cancer and had about a month left to
live. Feelings of frustrations and sadness started to rise from my stomach and
traveled up my body. Before I could stop it, my eyes welled with tears. One
tear escaped and slowly ran down my cheek. I brushed it away, embarrassed. I quickly
apologized to Julie, looked down at my notes, and started asking the questions
we needed. She interrupted.
“Liz, please don’t apologize. I think
this hospital is making me less human. Everyone is kind, but I’m being poked,
prodded, and thoroughly examined all day. I feel no connections to people. But
you, my dear, are displaying real emotion and that is making me feel more
human. It’s exactly what I need right now.” I grabbed her hand, my embarrassment
faded, and I could feel the remainder of the tear drying on my cheek. My
unexpected display of emotions had connected us. The hospital and its
procedures had temporarily dehumanized her, but my emotions, in that moment,
had helped her heal.
While emotions from healthcare providers
have the potential to negatively affect patient care, they can also be utilized
to support our mental health and, when used appropriately, improve care. The
first step in doing this is to take time to recognize and explore our emotions
in order to promote self-healing. Then, we can analyze our emotions and determine
how they might affect our clinical decision-making. We can use this to anticipate
potential problems emotions might create in patient care and subsequently craft
medical plans and reasonable solutions. Finally, and most importantly, we can
channel our emotions to enhance connections with patients and to increase
humanism in medicine.
