Doctors Don’t Cry

That’s not true.

Few weekends ago when I was working in the ICU, I met with a young doctor who works as one of our hospitalists, to talk about a patient that we just transferred from a regular floor to our ICU. It is a common practice for doctors to share with each other their opinions about patients so we could be in the same page.

The patient was in his 50’s who was very active and was in good health prior to his acute illness. His occupation was cleaning parks’ monuments and statues and he stays outdoors most of the time. Few days prior to admission he developed general malaise, vomiting, and high fever. Then he became weak and unsteady on his feet. He was hospitalized with a working diagnosis of a possible infection*. A day after being admitted, he developed extreme muscle weakness to a point of near flaccid paralysis that he cannot even lift his head or breathe on his own. That’s when he was transferred over to the ICU under my care. He required intubation and mechanical ventilator. His diagnosis was unclear and remained a mystery for us at that time.

Obviously the patient was not doing well and has a serious life-threatening condition. He may not even survive this.

While I was discussing with the young doctor about our patient, her tears were flowing. It may be rare but doctors do cry (see previous post) and can be overcome by emotion especially when they encounter difficult and sad cases just like this one. But for this young doctor it was more than that.

The patient involved was his father-in-law.

As doctors we are not immune of getting sick or having our loved ones getting sick. You may think we would react more composed as we usually deal with these bad news everyday. But no, our feelings could still get the better of us, and we could be more distressed as we have an insight of possible worse outcomes. I know, for I have dealt with that with both of my parents.

Doctors many times try to project an air of stoicism. We should have stiff upper lip when we’re dealing with awful situations. Which sometimes is misunderstood as being cold and insensitive. Is this a part of our institutionalized training?

As doctors we are trained to always have an objective view and not let our feelings rule over our decisions. Emotions can cloud our judgement. That is why it is better to have another doctor or a colleague take care of our loved one when they get sick, especially if their condition is really bad. But sometimes the situation cannot be avoided.

When I was doing rotation in the hospital as a 4th year medical student in the Philippines, there was a patient that was rolled-in to the Emergency Room with a large stab wound. The patient was bloody all over and had no pulse. One of my colleagues started doing CPR. As the patient had blood on his face it was hard to identify the patient. When it was clear that the patient was far gone, the CPR was called off. When the patient’s face was wiped clean, my colleague who was previously doing the CPR, realized that the patient was his cousin. He started CPR again but even more vigorously. Thankfully somebody else took over for him.

Here is another tragic story: during my Medical Internship in the Philippines, I was stationed in the Emergency Department with our Chief Medical Resident when we were informed that there was a patient coming via ambulance who had a cardiac arrest and CPR was in progress. When the unknown patient arrived, the chief resident immediately took over in running the Code Blue (cardiopulmonary resuscitation efforts), only finding out shortly that who he was trying to revive was his own father. She was openly crying while directing the code of when to resume or hold the cardiac compression for a pulse check, or what emergency medications to push, or when to deliver the electric shock to put the heart back into rhythm. This went on for several minutes that felt like an eternity.

I was amazed that she stayed collected and was still able to think despite the horrific circumstances. It was only after another senior medical resident from the floor who came down to the Emergency Department that she was relieved of her duty to run the Code Blue. Only then that she deteriorated into a full sob.

Doctors don’t cry? Perhaps not in public. Yet sometimes publicly too.

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(*Our patient was later on diagnosed with West Nile Virus infection – a mosquito-borne illness.)