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When is it O.K. to cry with your patient?

Posted Apr 20 2012 12:00pm

When is it okay to cry with your patient?

I think this is a really important question, actually. This past week in clinic has been really interesting, to say the least. I have heard stories of patients that have run from feelings of loneliness, abandonment, feeling like an outcast, tremendous loss through deaths of loved ones, hurt from friendships, to emotional/mental/physical scars from parental upbringings.

Questions of worthiness, purpose, and goals were prevalent and deep. It really is amazing what some patients will tell you in a patient visit. Just saying something out loud and having someone to listen to you is sometimes therapeutic in and of itself. I think there is a statistic running around family medicine circles, indicating that about 60-80% of “healing” that occurs is due to doctor-patient relationship. 20-40% is getting the correct diagnosis. Interesting. I think this really speaks to forming a relationship with your patient, listening to their pain, and making sure that they feel supported through their process.

So the next question is, how do you respond to hearing these heart breaking and heart wrenching stories of loneliness, fear, and unworthiness? One option is sitting in silence and holding the space, another is recognizing the difficult situation, and a third option is to explore the feelings around that issue and delving deeper into the subject. Which are you prepared to do? Which makes you most comfortable? Or more importantly, which makes you most uncomfortable?

Yesterday in the clinic was a very challenging visit for me. A woman came onto our shift for a first office call. She was referred to our shift from the counseling department for physical manifestations of depression and exploring what Naturopathic Medicine offers her situation (which, by the way, have a lot of tools to help a mental disorder such as this one). Loss of her parents, her husband, and both her mother and father in law happened within a 2 year period. Her story touched me so deeply that as I was taking notes on the visit, my vision began to blur from the tears that instantaneously welled up in my eyes. It was hard for me to see what I was writing, and I tried to hide the tears, but it was to no avail.

I looked at her crying and she looked back at me and saw the tears about to fall down my face and we had a true moment of understanding. I really empathized with her pain. It was real, it was deep, and it was intense. The primary clinician I was working with was great in that she led the patient through the intake, review of systems, and physical exam without breaking a sweat, or in my case, shedding a tear.

It was a really touching experience to meet this patient yesterday. So my question is (which might not have an answer), is it okay to have a patient see you cry with them, as they experience their emotional pain? I think it is. I think it humanizes the doctor, counselor, homeopath, what have you, as to really understanding where the person is coming from. Now, I am not saying that every sad story you blubber about and burst into tears, because as a doctor you have a role as physician and to maintain a professional attitude. But recognizing the pain that the patient is going through is also an important part of understanding and healing.

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