humanism in medicine

I don't know if it's normal for someone in medical school, but I spent a great deal of time before I came reading accounts of medical training and being, quite frankly, horrified - especially by accounts of doctors' training back in the 70's and 80's, and the way that the combination of sheer exhaustion, supposed objectivity, and professional perfectionism beat the humanism and empathy out of doctors. It almost sounded like accounts of being in combat: residents so tired they sometimes wished their patients would die so they could get rest; physicians feeling like they had to be perfect, not making mistakes, not being able to deal with the sheer emotions of dealing with death and life-changing diseases on a daily basis.

In Healing the Wounds, David Hilfiker writes about the struggles of being a rural physician, the impossibility of being emotionally and personally open to patients, and the difficulty the medical culture had with dealing with the emotions and pressures of practice*:

The blessing and the curse of medicine is that we physicians are privileged to share the most intense moments of life with our patients: birth, death, fear, sorrow, anxiety, disability, healing, joy. These moments are shared without the usual social barriers; thus, we are privy to the deepest of humanity's experiences....

But with this privilege comes the burden of availability, of openness to the needs revealed at those intense times. Not surprisingly, I could not sustain the degree of openness required to go from deepest need to deepest need, and consequently I found myself refusing the very service that a major part of me was committed to giving.

Some might find our course in humanism in medicine somewhat corny or a waste of time. For me, personally, it is extremely important to be able to see that medical education has changed significantly since many of the early accounts. Especially striking was the changes that were described: students transitioning from truly wanting to "help people" to simply attempting to survive, and in the process, having much of their empathy suppressed or even extinguished, and succumbing to cynicism in the process.

While I'm personally still a bit skeptical of how much empathy is going to survive the rigors of the training process, it is encouraging to see that medical schools have made it part of their curriculum in at least an attempt to bring this in. But it has to be something one is personally committed to. Three classes or even six about humanism in medicine can remind us that it is there, but not show us how to practice it.

*p. 37