Feeling Their Pain, At Home and At the Office

October 12, 2010

It’s strange to go from being the objective physician to the soft-hearted mom in the time it takes to drive home from work. However, I think the dual roles complement each other.

This is kind of a downer of a blog post. Bear with me, though.

One of the challenges of being a mom is that you have to watch your kids experience pain, disappointment, and failure at times. You would do anything to help them avoid these experiences, except that you recognize these moments can be essential for growth. Unfortunately, there are other moments you couldn’t spare them even if you wanted to.

As a physician, I also see patients experience times of unfortunate but necessary disappointment or pain - the sad realization that completely ignoring their diet and not exercising has finally caught up with them in the form of diabetes or having chemotherapy (painful and traumatic) to avoid a greater pain, death, or disability from cancer. Sometimes, you also see just unmitigated suffering that you are powerless to stop.

As a mom, I cry (sometimes figuratively and sometimes literally) when my kids cry. I hurt for them, even during times when I purposely hold myself back from intervening. My inaction can be a kindness in the long run - allowing a minor pain or disappointment to prevent a much greater one later. Moms are supposed to do this. We are hardwired to our kids’ emotions, experiences, joys, and pain. Hurting when they hurt, we sometimes choose to let the pain endure so that a lesson is learned, an experience is remembered, or a warning is reinforced.

As a physician, I’ve been taught and learned another lesson well - we are to be sympathetic, empathetic even at times, but we are not supposed to break our objectivity in order to walk the road with our patient as we would for a child, mother, or husband. Sometimes, I regard myself and think how cold I must appear to a patient who sits before me, crying, screaming, or wailing in pain (usually emotional rather than physical).

One patient who suffered from a combination of personality disorder and mental health problems never let an office visit end without hysterical crying. After the first two visits, I was no longer concerned that her crying indicated some urgent problem and would just let her know that I was going to get some work done until she was able to calm down and resume the visit. As tempting as it was to give in and play the hero by drying her tears, calmly soothing her battered psyche, or patting her hand while wearing a mask of sympathy, I employed my mom-like nerves of steel and stepped back in order to help her learn that there was little to be gained from playing the hysteria card. Unfortunately, I think she was too wounded to learn the lesson in her fifth decade of life.

It’s strange to go from being the objective physician to the soft-hearted mom in the time it takes to drive home from work. However, I think the dual roles complement each other. I often need to introduce some maternal tenderness into difficult patient encounters just as I occasionally need to be a little tougher at home and emotionally step back from my children’s tears.