What’s Love Got To Do With It?: The Emotional Toll of The Practice Of Medicine

In medicine, we are taught to be professional and, at all times, to keep our emotions at bay. While this approach may work for some professionals, I find it particularly challenging in medicine, especially in primary care. As a family physician, I have had the privilege of witnessing the journey of my patients over the years—sometimes spanning generations within a single family. I have seen my teenage patients grow into responsible adults and parents. I have cared for pregnant mothers, witnessing the joy of welcoming their babies into the world and observing those children grow, from their first tooth to their first words and steps. Then, before I knew it, those children grew into teenagers. I have also had the privilege of caring for my older patients as they aged, supporting them as their health declined, and sometimes delivering difficult diagnoses and witnessing the subsequent decline in their health. For some of these patients, I have been present during their last months, weeks, days, and sometimes hours of life. Simply typing these words brings a nostalgic sigh as I reminisce about these moments.

Given all of these experiences, how does one separate their humanity, empathy, and the close patient-physician bond, and not be impacted over time by the thousands of lives they have had the privilege to interact with?

When you truly listen to your patients and endeavor to understand them by putting yourself in their shoes, how do you detach from the emotional impact?

In medicine, there is a concept called compassion fatigue. Compassion fatigue is the emotional and physical exhaustion that can occur when caregivers are unable to refuel and regenerate. It’s a condition characterized by a gradual lessening of compassion over time. It can manifest in feelings of hopelessness, a decrease in experiences of pleasure, constant stress and anxiety, and a pervasive negative attitude. Research suggests that healthcare professionals are at a high risk of experiencing compassion fatigue due to the intense emotional demands of their work. It can lead to a diminished capacity to provide effective care and can have detrimental effects on both the healthcare provider and the patients they serve. This highlights the importance of addressing this issue in medical practice.

To combat the emotional toll of medicine, here are five actionable strategies:

1. Have a life outside of work that is not related to medicine: Please don’t let your life revolve around work. You need to detach yourself from it, watch a comedy show, explore hobbies, or stay up late with friends watching movies and laughing.

2. Recognize that your feelings are valid, but acknowledge that you did the best considering the multiple factors involved in patient care: In my career, I remember a first-time patient presenting to my office after 12 months of rectal bleeding and weight loss. Despite the challenging diagnosis, I did the best I could. Having family members of the patient ask me about the diagnosis was tough. Trying to convey to them that the prognosis was not good wasn’t any easier.

3. Practice self-care: In my experience, when I let go of unnecessary stressors and significantly lightened my workload, I was able to think clearly. When I found a better work situation that gave me more autonomy and significantly less administrative work, it was much easier to prioritize self-care. Self-care might look different for everyone, but I strongly recommend self-development as part of your self-care routine.

4. Let off some steam: Obviously, you want to do this in a constructive manner. Examples include exercise, journaling, or engaging in hobbies that bring joy and relaxation.

5. Establish healthy boundaries: It is not okay to repeatedly sacrifice breaks for nutrition just to “squeeze in one extra patient.” As much as possible, create healthy boundaries and maintain them firmly.

As healthcare providers, we must nurture our humanity while navigating the complexities of our profession. By acknowledging our emotions, practicing self- compassion, and establishing healthy boundaries, we can continue to provide exceptional care without sacrificing our own well-being. In doing so, we honor the sacred bond between patient and physician, ensuring that love remains an integral part of our practice.

So, as we continue on this journey, let us carry with us the lessons learned from each patient encounter, the strength gained from overcoming adversity, and the compassion that binds us together. For in the end, it is not just about what we do in medicine, but the love and empathy we bring to every interaction that truly matters.

Until next time,

Dr. Tomi Mitchell