Suddenly, I was plunged back into an avid learning environment, starting at the bottom and working my way painstakingly up the mountain. The thrill of learning and accomplishing stimulated me so much that the work was pleasurable.
Grief ate at these doctors, distracting them from both their families and their patients. Many reported withdrawing from emotional involvement with their patients and that their patients had noticed they weren’t fully present.
Empathy–the ability to identify with someone else’s suffering–is certainly a prerequisite for a genuine apology.
In general, empathy is easier the more we can identify with someone. When we can genuinely envision ourselves in a situation, it’s possible to intuit what that person’s suffering might feel like.
It can be rough going to maintain both composure and empathy in these situations, but a doctor’s failure to do that is probably the number one reason why patients feel dissatisfied with their physicians and end up doctor-shopping endlessly.
But while the patient does bear some responsibility, I believe that the onus falls more heavily on the doctor to be attuned to the factors–cultural, ethnic, or just personal style–that influence how patients present their symptoms.
Hospital life–with its byzantine array of moving parts layered atop the unpredictable rhythms of illness–is a permanent state of flux.
But I realized that not only did I need to keep tuning my skills as a doctor, I also had to figure out a way to live with the uncertainty of medicine and its attendant anxiety.
Burnout also leads to a large swath of physicians who aren’t as empathetic toward their patients as they could be.
But at the most basic level, doctors need to be able to come forward with their errors and near-misses, otherwise we will never know where the problems lay.
Neuroscientist Antonio Damasio describes emotions as the “continuous musical line of our minds, the unstoppable humming.” This basso continuo thrums along while doctors make a steady stream of conscious medical decisions.