Well, if I'm your doctor, chances are probably not. This isn't because my patients are not comical or stupid - they often are. But rather, it's because with all the demands that residency puts on you there is just no frickin' time! To laugh at someone takes extra planning and energy that can much better be spent catching up on discharge summaries, taking in a sporting event, sleeping or laughing at ER Stories's patients. But, for me, the answer is 'no,' I never laugh at my patients. Neither do I tend to engage in other unnecessary and time-consuming activities such as empathizing with my patients. There is generally more than enough patient-related work to keep us residents occupied without piling on these extra tasks.
However, a recent CNN article reported that 17 of doctors had admitted to having made fun of a patient while he or she was under general anesthesia. Such behavior is described by this article as "unprofessional." It continues to irk me to no end that stupid shit like this still gets media coverage. If you want to call this kind of behavior unprofessional, that's fine by me. But do not then write about unprofessional behavior as if you're writing about something meaningful.
The term unprofessional, as it relates to medicine, is currently used as a catch-all term for any behavior that we don't like to see doctors engaging in. Anyone who uses it is invoking his own set of values, biases and opinions which may or may not have any bearing on the topic of discussion. I do think there are certain behaviors we, as a society are entitled to expect from doctors in exchange for granting them a license to practice medicine. For example, we are entitled to expect them to respect confidentiality, to provide medical care based on the most current evidence, to disclose all financial relationship when giving talks on disease management etc. Are we entitled to expect that our doctor won't laugh at us while giving us excellent care? No. Most doctors won't laugh at you - for the reasons I mentioned above. But I find myself under no obligation to refrain from holding my side and bending over in a hearty guffaw over whatever mess you've gotten yourself into. I hope you don't take offense. I am, after all, very sincerely trying to help.
4 Comments
Dear James,
After listening to your comments, this will be the last time I knowingly speak to a resident like you without telling you off a time or two. I added my comment to the Wilderness Medicine Blog regarding AEDs and discovered your website afterwards. You really are an arrogant jerk aren't you? In your suicide article you make the important point that the patient saw the physician a week prior to the completion of suicide. Then, two articles later, you talk about the fact that basically, no one is allowed to tell you to knock it off when you are laughing about "what I got myself into". You go on to say that you do not empathize, thus preventing time wasting, with your patients. Why don't you become a plumber so you can't hurt something with feelings and if you aren't real careful, you'll be covered in shit when you least expect it. You could see how it feels to be on the receiving end.
You don't have time to empathize with your patients because you are just too busy, blah, blah, blah, you cry baby. You know what Jimmy? You do have the time...You just don't "make the time". You seem to have enough time to write all these articles, right? And I'd bet dollars to donuts that if that person was important to your position or reputation, you would truly give an academy award performance to at least "try" to appear that you were empathizing. It all comes down to your ego, which seems somewhat maniacal. All residents and physicians with your attitude are in truth, real chickenshits. The only time you give your real feelings is when you can hide behind a website/page/blog. I love finding residents that have your personality traits (yes, you are so transparent to me, a complete stranger, that I can see it in your words). I'd be the first in line to tell you to knock your "stupid shit" off. Somewhere down the line, you either flunked or did not finish any class or coursework in human dignity. And most likely, nothing has ever happened in your pathetic, spoiled, little life that might cause you to know how to even fake empathy, let alone know what it feels to need it when there is nothing else that can be done. You are just another phony. Yes, Resident Phony Jimmy. What is really "funny" is, that you think no one knows the true phony Jimmy. But your kind is seen by everyone who knows you J. You think you are so superior and that YOU, yes YOU, have the edge.
In your heart, you are in the medical profession for what it can do for your ego. I bet your whole life is wrapped around how good you can make yourself look, and at any expense. You do have a difficulty with time. Your type has to spend a lot of time trying to look cool so you can keep the truth of your phoniness hidden. So stop speaking Jimmy and work on that heart if you can find it. Why don't you try using your useless stethescope to try and locate it. Good luck. You'll no doubt need it.
Doc Blackjack
Ouch! Harsh words from Dr. Blackjack.
The only thing I really take issue with is being called a "phony." Whatever you want to say about my personality, I'm not a phony. I'm just a loudly, openly and unabashedly unempathetic person.
No, that's not really true either. The point of my post is that I don't think the practice of empathizing with people in and of itself is either necessary or relevant to the practice of medicine. I believe that the best way to build patient trust is not by engaging in overtly empathetic gestures like holding the patient's hand and telling them you're sorry, but by demonstrating to them that you are honestly and sincerely trying to help solve their problem.
Anyway, I do hope my readers believe me when I say I'm not a phony; I am equally unempathetic whether I am one on one with a patient or whether I'm being observed by the Dean of the Medical Center. The part about being an egomaniacal prick on the other hand..I think you used the word "jerk" but, in any case, you were dead on about that.
As a member of the general public, with no medical connections and no axe to grind, I find the idea of my doctor laughing at me disgraceful. I want my doctor to be friendly, approachable, well qualified, with a good bedside manner. If doctors are in the profession 'for laughs' or for their own egos they need to get a new job.
I have to disagree with you there, Judith. If your doctor in the porfession "for laughs" or for ther own egos and you don't like that then you need to get a new doctor.