Should doctors burst into tears at work? Over my dead body!

Ideas

Should doctors burst into tears at work? Over my dead body!

It only blurs the boundary between doctor as detached professional and patient as suffering client, a doctor insists

Dr Michel Fitzpatrick


A recent feature in the British Medical Journal seeks to reassure doctors that “it’s okay to cry at work”. The author quotes an Australian study in which doctors explain that the main reason for crying is their “identification and bonding with suffering and dying patients or their families”.
According to Caroline Walker, a psychiatrist and psychotherapist specialising in doctors’ wellbeing and founder of Joyful Doctor, an organisation that supports struggling doctors, crying with patients is about “being with them in the moment, being real and honest”.
This suggestion, emphasising the emotional needs of the doctor rather than the patient, has all the sincerity of the Ali G catchphrase, “Keep it real”.
For Seamus O’Mahony, gastroenterologist and author of Can Medicine Be Cured?, the introduction of training in empathy into the medical curriculum is a symptom of the “corruption of a profession”. In a chapter entitled “The Mendacity of Empathy”, he identifies in the promotion of the concept of empathy a “glutinous mixture of virtue signalling, pseudo-biblical language and a social justice agenda”.
He distinguishes carefully between the notion that it is possible for a doctor to share a patient’s mental state and the concept of compassion, which requires “kindness, courage and competence”.
O’Mahony advocates “courtesy, dignity and kindness”, rather than the “vulgar, embarrassing and intrusive” conduct of the BMJ’s weeping empathetic doctor, which “cheapens, undermines and coarsens the doctor-patient relationship”.
The “smug and pretentious” jargon of empathy is but one manifestation of what O’Mahony diagnoses as a wider “crisis of bottom” in the medical profession, a decline in personal substance and integrity among doctors who are “bullied by managers and scared of patients”.
In the face of the “global domination of the medical-industrial complex” and the challenges of consumerism, paired with unrealistic expectations that produce public disenchantment with medicine, he is not optimistic. Yet, I am sure that his appeal to uphold professionalism and clinical judgment would benefit patients much more than expecting them to mop their doctors’ tears.
Personal experience
My antipathy towards the notion of doctors crying with patients is linked to a wider conviction that we are ill-advised to share personal experiences of ill health with our patients.
I have always taken the view that telling patients that you have endured a similar affliction blurs the boundary between doctor as detached professional and patient as suffering client. I have to confess, however, that I have recently broken my own rule of personal non-disclosure – over a wart. A mother presented her son with a wart on his finger, requesting some form of cautery. I immediately displayed the wart on my right thumb, indicating that, if I knew of any effective treatment, I would have used it myself. I explained that long experience of freezing warts and verrucae in my minor surgery clinic has led me to the conclusion that the best thing is to leave them alone and await their spontaneous resolution.
– © The Daily Telegraph

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