Meanwhile, some oncologists begin to distance themselves from patients and their families toward the end of life. While patients and families may misinterpret this behavior as a signal that the physician is uncaring, the reality is often just the opposite. “They care very deeply, and the feelings are so intense that their way to cope is to distance,” she says.
Whether to step back is an individual decision, Granek says. While for some physicians, it relieves them of pain they can’t tolerate, for others it can add to feelings of guilt.
Finally, physicians must adopt self-care regimens that proactively help them weather the emotional ups and downs of the profession, Karlekar says. Fundamentally, this means sleeping well, nourishing oneself with good food and engaging in stress-relieving activities.
“I don’t want to preach that everybody has to draw or write or meditate, but you have to find something outside of what you do as a profession that brings you some balance and meaning,” she says.
The key is to use these tools on a regular basis, not just in reaction to difficult emotions. “If you are constantly trying to keep yourself well, even when things get really bad, you’re not going to fall apart,” Karlekar says.
Debra A. Shute is a freelance journalist based in Worcester, Mass. Debra has been writing about healthcare since 2003.
Understanding malpractice grief
A physician’s psyche can also suffer a dangerous blow when faced with a malpractice suit, says Ilene B. Benator, MD, author of How to Survive a Medical Malpractice Lawsuit. Benator, an emergency physician, was sued twice early in her career. Although one case was dismissed after the deposition and she won the other at trial, she describes the experiences as devastating.
“Doctors go through a lot of hardship to get where they are,” she says. “So when you’re being told that you might not be good, it really hurts you at a core level. It hurts psychologically, and you’re also hurt financially. You second-guess yourself. You worry if you’re going to be employable.”
However, a physician’s state of mind can make or break an effective defense, Benator says. She encourages physicians to seek from their attorneys not just legal advice but help quieting doubts that can sabotage a case. “If you’re a defense attorney in medical malpractice, I would like to think that’s part of your job — to inadvertently do a lot of counseling to get clients ready for trial. They’re probably not going to be good at trial if they’re a mess,” she says.
While other physicians are generally very compassionate to colleagues who have been sued, it’s unadvisable to discuss factual details of an active case, Benator notes. However, she does suggest talking about emotions with professional therapists, if possible. “It’s one venue where you’re allowed to talk about your case without consequence.”
She also found solace in reading online about other physicians’ experiences with malpractice. “Connecting with other people who have gone through it makes you feel less alone in how you cope with it,” she says. Facebook, Twitter and other social media platforms make it easy to find people who have been through similar experiences. “You don’t even have to participate. You can follow a thread and see what everyone else has dealt with. It really puts things into perspective,” Benator says.