Emotionally Scientific

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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.