As a medical student, Dr. Elizabeth Levin cried while caring for a breast cancer patient. In the process, Dr. Levin admits, she upset the patient and made a difficult situation even worse. Patients say they want doctors to show compassion, but do patients really want medical professionals to express empathy in the form of tears? “It’s okay to cry,” Dr. Levin now says, but only if you understand what that phrase really means.
Students learn about more than anatomy, cell biology, and biochemistry during their first year of medical school. For Elizabeth Levin, orientation alone was educational. As she explains in recent JAMA article called Learning to Breathe, a young palliative care physician told incoming students that crying in front of patients was acceptable. Levin thought she understood what that meant, but then there were consequences.
Is is acceptable to cry in front of a patient?
Levin’s relationship with the breast cancer patient had been close, but the medical student’s outburst crossed a line. The patient “felt crying was a sign of weakness,” Dr. Levin now writes, and was distressed by the experience. Although Levin shared her phone number with the patient, there was no subsequent communication. “I never heard from her again,” Levin notes, “and I always wonder if it is because I cried.”
Later, during a guided meditation for a course in mindfulness-based stress reduction (MBSR), the fourth-year medical student found a measure of clarity. During a subsequent MBSR session, Levin learned about the importance of breathing as a way to control her emotions during difficult situations with patients. Patients may say that they want doctors to show compassion, but it’s better to show that you care than to cry.
Today, Dr. Elizabeth Levin works for the Department of Internal Medicine for the Hennepin County Medical Center in Minneapolis. She credits the MBSR course with providing her with practical tools for dealing with difficult situations. “I learned to show compassion for my patients without being distant or letting myself suffer,” she writes. “None of these experiences would have been possible had I not learned to breathe.”
What techniques do you use?
Have you ever been in an emotional situation with a patient? What helped you to manage your emotions and prevent burnout?
