Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life's most challenging moments. But doctors' emotional responses to the life-and-death dramas of everyday practice have a profound impact on medical care. And while much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. In What Doctors Feel, Dr. Danielle Ofri has taken on the task of dissecting the hidden emotional responses of doctors, and how these directly influence patients.
How do the stresses of medical life-from paperwork to grueling hours to lawsuits to facing death-affect the medical care that doctors can offer their patients? Digging deep into the lives of doctors, Ofri examines the daunting range of emotions-shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love-that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Danielle Ofri offers up an unflinching look at the impact of emotions on health care.
With her renowned eye for dramatic detail, Dr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients and her forever fear of making another. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. But doctors don't only feel fear, grief, and frustration. Ofri also reveals that doctors tell bad jokes about "toxic sock syndrome," cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness. The stories here reveal the undeniable truth that emotions have a distinct effect on how doctors care for their patients. For both clinicians and patients, understanding what doctors feel can make all the difference in giving and getting the best medical care.
About the Author
Danielle Ofri, MD, PhD is an associate professor of medicine at New York University School of Medicine and has cared for patients at Bellevue Hospital for over two decades. She is the author of Singular Intimacies: Becoming a Doctor at Bellevue, Incidental Findings: Lessons from my Patients in the Art of Medicine, and Medicine in Translation: Journeys With My Patients. Ofri is a regular contributor to the New York Times' Well blog as well as the New York Times' "Science Times" section.
Ofri adroitly balances presentation of her own experiences and those of others, with research into the emotional aspects of medical practice. The result is a fascinating journey into the heart and mind of a physician struggling to do the best for her patients while navigating an imperfect health care system that often seems to value “efficiency,” measured in dollars and minutes, more than the emotional well-being of either physician or patient.
Students are not just learning medicine during the third year of medical school; they are learning how to be doctors. Despite the carefully crafted official medical curriculum, it is the “hidden curriculum” that drives the take-home messages. The students astutely note how their superiors comport themselves, how they interact with patients, how they treat other staff members. The students are keen observers of how their supervisors dress—and how they may dress down those around them. They figure out which groups of patients can be the object of sarcasm or humor, and which cannot.
On a daily basis, the students witness fear, anger, grief, humiliation—in patients and doctors alike—all of which are largely unacknowledged. They see egos rubbing up against each other, hierarchies at play, bureaucracies in action. They observe that many of the niceties of patient care fall prey to the demands of efficiency and high patient turnover. Much of what they learned about doctor-patient communication, bedside manner, and empathy turns out to be mere lip service when it comes to the actualities of patient care.
I never told anyone about my lapse — not my intern, not my attending physician, certainly not the patient’s family. I tried to rationalize it: the radiologist had caught the bleeding, and no additional harm had come to the patient.
But what if I had discharged the patient? What if I had started her on a medication like aspirin that could have worsened the bleeding? My error could easily have led to a fatal outcome. The patient was simply lucky.