A Better Doctor

As emergency physicians, we see everybody who comes through the door. Our patients vary from the easy-to-treat to those at the end of life. They may be young or old, acutely or chronically ill, mentally retarded to intellectually gifted. Their diseases or injuries may be new or complications of long-term malady. Yet, both patient and physician share one commonality—we are human. We each feel pain, joy, sorrow, and the whole gamut of emotions when life is fully lived. 

As physicians, we have the gift of being able to witness new life, mental and physical suffering, and death, sometimes sudden and other times after a lengthy debilitating physical illness. We witness immediate relief of pain and unimaginable suffering as well. Through our career path, and the many individuals and families who have taught us how to live a wiser life, we have learned to expect and prepare for the unexpected, shoulder the heavy burdens of life with grace, and to die with dignity and a sense of fulfillment. 

Sometimes we see only wasted life and sorrow. Some may decide to turn their emotions off in an effort to manage the overwhelming cruelty or sorrow we often witness in the emergency department. On the other hand, others choose to acknowledge the courage and dignity of so many of the patients we treat. It is when we touch and acknowledge those emotions within ourselves that we begin to feel true compassion and empathy. 

We see our patients and their families only sporadically or at the time of an acute crisis. As such, we often only have short windows of opportunity to get to know our patients, but the time we spend with them is when they are the most vulnerable. While I don’t believe there is any formal education on patient interaction, one must wonder whether their needs to be? Isn’t it more an awareness of our own personal development that allows one to cope and communicate our personal connections with patients honestly? 

Demeanor

We are trained to see patients as quickly as possible (in order to decrease waiting times and unclog the emergency department), obtain a history and physical, order appropriate labs and x-rays, make a diagnosis, and make an appropriate decision for treatment. Physicians are often standing at the end of the bed or in the doorway, often with our hands folded or arms crossed, making minimal eye contact, and little effort to hide our “busy” attitude, machine-gunning questions at the patient and barely waiting for a response from the patient. 

Now consider taking that same assessment time, but instead presenting oneself in a caring stature with open body language, eye contact, and even sitting on the patient’s bed, if appropriate. Replace the busy demeanor with a calm attitude and listening ears and you now are “caring” for your patient. 

We have all witnessed how some of the most brilliant practitioners fail miserably in projecting a sense of care to their patients. Perhaps it takes being a patient oneself in order to appreciate this aspect of medicine. Being on the other side of the bed rails, so to speak, makes one realize how it feels to be approached in a caring and sensitive manner. 

Bedside manner is extremely important during our interactions with our patients and their families. And remember, what seems like a simple gesture may make all the difference to the patient, who will now get the sense that their doctor truly is concerned for their well-being.

Empathy

The physician author of the heart-touching condolence note that was recently posted on Reddit demonstrates a sense of compassion and empathy. This physician was able to articulate the genuine emotion and connection felt between doctor and the patient and her family. She may have been a practitioner, but she was also a person and approached treating the patient with human emotions. 

As I think about my long career in health care, I can truly say that I have learned more from my patients than I would have learned in a formal classroom setting. I am not jaded. In fact, I feel more empathy for my patients now than I did as a younger physician. Life has helped me to appreciate the personal impact of the suffering I witness. It has taught me the importance of simple kindness in my approach and genuine empathy for the plight of my patients. 

I have witnessed tragedy and heartache, as well as reveled in the joy of a successful treatment. I commit to following that physician author’s example and allowing myself to become fully vested in the care of my patients—to accept the gifts they so generously share and by personally writing to follow up and stay in touch with those who impacted my life. I will better acknowledge the emotions that my patients stir within me to truly understand and connect with those entrusted in my care. 

While the shifts I work are busy and sometimes seem overwhelming sad with the misery of illness and accidents, they are also filled with life lessons and great opportunities to learn and practice empathy and compassion. We can choose to learn and grow in this rich environment of humanity, or we can choose to use denial, block our own self-development, and ultimately, contribute to our emotional demise. ■

Susan Effron, MPA, BSN, is a lifelong health care provider and manager engaged in various health care settings including hospice, home care, emergency nursing, and public health.

David Effon, MD, is an assistant professor of emergency medicine at Case Western Reserve University, attending physician in the department of emergency medicine at the MetroHealth Medical Center, and consultant emergency physician at the Cleveland Clinic Foundation, all in Cleveland, Ohio.