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There are people who, instead of listening to what is being
said to them, are already listening to what they are going
to say themselves. Albert Guinon.
One of the commonest complaints patients have about doctors
is that they are too distant and uncaring. Perversely, many
doctors still pride themselves on their detachment and equanimity
- and distancing oneself from the patient is one of the first
skills we learn as medical students ! However, medical practice
is not an either-or situation, and doctors need to practise
both science and art, reason and intuition, attachment and
detachment, equanimity and empathy. These are not mutually
exclusive – and the good doctor needs to find the right
balance !
Unfortunately, we do not encourage our medical students to
develop their emotional skills, and medical college usually
drains whatever natural empathy students have. Students get
marked for their academic excellence, cramming ability and
surgical virtuosity – not their ability to establish
a rapport with their patients ! Medical college professors
rarely demonstrate empathetic skills – so who are students
going to learn from ? By overworking residents and forcing
them to cram tomes of scientific information, we often end
up dehumanizing them . This means that after 6 years of medical
college, instead of producing doctors who should be able to
understand a patient’s pain and suffering, we turn out
unfeeling surgical automatons - what a shame !
Some doctors are naturally blessed with empathy
, while others need to learn it. However, it can
be learnt and taught – and is as important
as learning to tie a surgical knot and to start
an IV line ! Time , age and experience often bring
empathy along with serenity – and doctors
who have suffered themselves ( or whose family members
have experienced suffering) are much more likely
to be empathetic than others.
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One of the best ways of developing empathy is to become a
patient yourself ! When physicians fall sick themselves, they
learn the value of empathy the hard way ! Seeing things from
the other side can be very educational – and many doctors
are quite shocked to realize how badly the medical system
treats patients in general. Unfortunately, they only learn
this when they are at the receiving end, but many do improve
their own bedside manners as a result of this experience !
In fact, a medical school in the US admits their medical students
as patients in a hospital ward for 2 days, so that they can
experience firsthand how it feels to be a patient in a strange
, hostile and threatening environment.
Reading books written for patients can also be very educational.
The consumer health literature has now become voluminous,
and unlike medical text books, these extensively cover the
emotional effects of the illness and how to cope. Since these
books have been
written for patients, they are patient-centric, and eloquently
present the patient’s view point. Books written by patients
which describe their first-hand experience are particularly
valuable, and can serve as an eye-opener if you try to feel
the story as the patient feels it ! Just as artists learn
to see by drawing, so doctors can learn empathy by putting
themselves in their patients’ place. “ Pathography”
- the stories of illness from the inside - can help nourish
empathy.
The internet is also very valuable, since there
are so many personal websites which present the
patient’s experience with his illness. Online
bulletin boards , chats , mailing lists and newsgroups
which invite patient participation are all very
useful as well. Not only can you contribute your
wisdom as a medical professional , if you keep an
open mind, you can learn a lot about what it feels
like to be in the patient’s shoes. Unlike
Indian patients, many in the West are very articulate
and demanding – you can learn a lot from them
!
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Is there a downside ? Empathetic doctors can sometimes lose
their objectivity, and when you get attached to your patients
, their grief becomes your grief, and their sorrow becomes
your sorrow. Is this bad ? I don’t think so ! I think
this is part of being human, and we should allow ourselves
to experience feelings ! As a doctor, we have the unique privilege
of sharing our patient’s innermost thoughts, and we
should try to make the most of this privilege, rather than
try to wall ourselves off.
Learning empathy is very valuable in improving the medical
care you provide. Just talking to the doctor can be therapeutic
for many patients, and conveying empathy lies at the heart
of a physician's supportiveness. We need to remember that
doctors are active healing agents – and often far more
potent than an antibiotic !
It is true that there will be some days when you
will find it much easier to respond to your patient’s
feelings – and some days ( when you are feeling
burnt out ) when you couldn’t care less !
Also, some patients are much easier to empathise
with than others. However, if you do try to consciously
develop your empathy skills, this will help you
to take better care of your patients, become a better
doctor – and even more importantly, become
a better human being !
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