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Doctors vs. Healers

Updated: Sep 12, 2023

We don’t always choose to tap into the power of our emotions. Our reluctance frequently comes from our background, as the transformation required to channel our feelings is uncomfortable, forcing us to examine our biases and sit with them. Even though we are inherently born with this ability, there is a catch. Like any wild force, our emotions can be unruly and hard to contain, even dictating our actions if we are not careful.

Take, for instance, the story of my favorite Disney superhero. Moana is an adventurous girl who sets sail on a journey across the ocean to save her island by restoring the heart of a powerful goddess. Moana can’t save her island from an impending ecological disaster until she embarks on an unpredictable voyage into uncharted waters, a powerful metaphor for self-discovery. Confronting her fear catalyzes an internal transformation that allows her to unleash the courage and determination needed to face the wrath of Te Ka, the lava monster. Although she has no traditional superpowers like the superheroes in Marvel, her bravery and unwavering perseverance allow her to break through the enraged surface of the lava monster to find the gentle and benevolent goddess, Te Fiti, underneath. That’s what truly defines a superpower. When our self-confidence overflows into influence, allowing us to wield our newly discovered capabilities for extraordinary purposes. This starts with self-awareness. This starts with sorting through our emotion.

Similarly, I had to sort through emotion when I was called to evaluate Sara*, a spirited woman in her late 80s, for a heart valve operation. When I discussed her condition with her family, they confided she was weary of doctors and hospitals. Throughout her life, her experience seeking medical care had been tainted by feeling dismissed and rushed.

Sara’s daughter explained, "She was trying to tell him the shortness of breath was worse, but he interrupted her, telling her it was her age. I was there." Her daughter conveyed this anecdote emphatically, citing her frustration when she took her mom to an appointment with the primary care doctor two years ago.

After this visit, although Sara’s shortness of breath worsened, she never returned. As it turned out, it wasn't Sara’s age. It was her valve. She needed open heart surgery. At first, she refused. Although hostile on the surface, I could sense the underlying mistrust as we spoke. Her fear simmered beneath her stoic surface. Her exasperation was vaguely directed at the entire healthcare system and had been brewing for years. When I came back to see Sara, she was with her family. They had convinced her to listen to all the options. I was honest with them. Her disease had advanced and would certainly present hurdles in her post-op course.

As doctors, we sometimes encounter patients who are hostile, rude, and unwilling to engage in conversation. Simply put, it's frustrating. It’s easy to take these unpleasant encounters personally. We all deserve to be treated with respect and courtesy. The irritation is reflexive, and it's crucial to recognize it. But how we react to it is our choice. We, as physicians, can accept that the frustration we experience from patients during these interactions often stems from deeper issues within a flawed healthcare system. Understanding this helps to depersonalize the situation and diminish its impact, making it more about the patients and less about ourselves. When it's not personal, it loses its power.

Sara remained reluctant, but after lengthy discussions with her family and our palliative care team, she determined she wanted everything possible done. She got a new valve and did fine. She was discharged five days later, and I next saw her at her post-op appointment. She brought me a bouquet of yellow roses, handbound with cellophane and twine. She was gardening again, her favorite pastime. Her shortness of breath before surgery had become so severe that she could only walk from the couch to the bathroom.

"I was just waiting to die," she said. Like so many other women, pre-existing biases of the healthcare system left Sara at a disadvantage.

Healthcare disparities based on gender leading to delays in diagnosis and treatment in women are so common that they are almost a cliché, as depicted in the Netflix comedy “Wine Country.”

“This is why more women die of heart attacks right here!” exclaims Rachel Dratch’s character amid an emergency room encounter where the ER doctor insists her friend’s snake bite was probably just a run-in with a “sharp twig.”

The lighthearted and comical scene starkly contrasts the dark honesty of the glaring gender disparities it depicts. But what can we do as clinicians?

As a healthcare community, we must recognize the pattern and study it. But how can we apply the knowledge as individuals to create a better line of communication between ourselves and our patients?

It starts by sorting through emotion. It's a controversial statement. The classic teaching of medicine is to put logic above all things. We worship at the altar of numbers and cold, hard facts. We understand statistics and translate them into practice. We regard guidelines as the holy grail. That part is drilled into us. It's how we are trained.

But is that enough?

Not until we sort through our emotion. Not until we do the inner work and shed light on our biases. We can treat our patients to the best of our abilities by seeing them through this lens.

Can bringing emotion back into our work elevate us from doctors to healers? That’s our ultimate superpower, ready to be realized and leveraged to its full potential.

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