[ Medical School Resources | Appendices | Discussion ]
"They mistake having no feelings for being smart" - Steven Bergman.
From Konner's Becoming a Doctor: A Journey of Initiation in Medical School:
Far from being embarrassed by brusqueness, residents are more likely to be embarrassed by (and to consider not quite professional) acts and gestures that are other than completely instrumental.... [Sadly, writes one student,] during the last few months on the wards I tried to be decent to patients, but my bonds, my emotional energy... were all with doctors and medical students.... Relations with [patients] should be smooth, cordial, and efficient, but they are certainly not personal.... I have been absorbed into the 'teamness' of medicine.
Another student's story:
We often learn to define our roles as students... by cataloging those behaviors that have either brought us praise or scorn.... Mr. A informed me that it was his 50th birthday. Later, as our team stood outside Mr. A's room I mentioned it was his birthday and suggested we sing happy birthday to him. The interns and residents turned to me, staring incredulously.... Throughout the rest of the day, I was subjected to ridicule for my naive suggestion. This experience left me very hurt and confused - obviously my suggestion was ridiculous, at least to the medical staff, and I learned from this episode never again to suggest such ideas.... It was through the not-so-subtle technique of ridicule and scorn that the medical team guided me toward what they considered to be proper behavior.
A study of three medical schools found that medical training fostered detachment towards patients, a desire to know them only on a doctor-patient basis. The authors thought this may be, "the result of a developmental process, a correction of youthful idealism into a more realistic outlook...."
An article entitled "Crying in Hospitals" compared the experiences of doctors, nurses and medical students. "Medical students reported the highest percentage of negative social consequences of their own crying (e.g., being ridiculed or screamed at)." From an article called "When Babies Die":
Residents are systematically taught to suppress their own feelings and along with them, any display of emotion. Residents are provided no outlet for talking about their feelings or even admitting that they have them - and residents who do show emotions are publicly sanctioned.
A faculty physician who observed a resident hold the hand of a patient and weep with her when she was told her term fetus had died, called the resident out of the room. The resident was sent home for the day (something unheard of in this program) and told to come back 'when you can act more like a doctor'.... The lesson was not lost on the other residents, nor on the resident who was sent home, who >vowed never again to show emotion to a patient.
The reasons why so many of us are crying - Appendix 10b.
 Shem, S. Mount Misery New York : Ivy Books, Jan. 1998:42.
 Konner, M. Becoming a Doctor: A Journey of Initiation in Medical School New York, Viking, 1987.
 Rosenberg, J. "Life on the Wards." Medicine as a Human Experience Ed. Reiser, DE and DH Rosen. Baltimore: University Park Press, 1984:1-19.
 Rezler, AG. "Attitude Changes During Medical School." Journal of Medical Education 489(1974):1023-1030.
 Wagner, RE, et al. "Crying in Hospitals." Medical Journal of Australia 166(1997):13-16.
 Graham, SB. "When Babies Die." Medical Teacher 13(1991):171-175.