Question from Medical Student: OK to Cry?

I recently gave a Sorry Works! presentation to a group of medical students. I love teaching medical students...they're not jaded and it's cool to think about where they will scatter --- with the disclosure message -- in four years or less.  So, during Q&A one of the students posed the following question (and statement): "Is it OK to cry with a patient or family?  Is it acceptable to show emotion?  I have heard historically in medicine that doctors (and nurses) were not allowed to display emotions, and as a student today I still get the feeling we should keep our distance from families and put on a brave face no matter what."

My response: I love it when healthcare professionals show emotion, but I am scared when a doctor gives a robotic response to an overwhelming tragedy.  I want to be treated by a crier/hugger as opposed to a robot who appears not to give a damn.  Physicians need to be able to treat the whole person, and our emotions and mental health are as important as any organ or blood vessel.

This question reminded of another question/statement from a resident.  This young doctor had a little girl die on his watch...he did all he could medically with the parents crying their eyes out in the corner, but when the child was finally declared dead the doctor quickly left the room "because he had other patients who needed him."  The resident asked what I thought of his behavior.  I gently responded: "Your next patient could have waited five or 10 minutes while you comforted the parents....we wait all the time for you guys, what's another 10 minutes when you are dealing with a dead child?  And when you finally got to the next patient simply apologize for being late and explain you were comforting grieving parents, and that next patient will completely understand."

The resident thought about my response, then asked another question: "Every day when I drive home I travel past a Hallmark store, and I've thought about getting a sympathy card for the parents, but I've never done it, and now we are six weeks past the death, am I too late?"   My response: "Six weeks is the point in the grieving process when the flowers have died, the sympathy cards have stopped coming, and co-workers and neighbors want grieving people to 'act normal' again...but they can't!   So, you sending a card with a simple message and perhaps including your business card welcoming a phone call might help those parents get through their day."

And this all leads up to the ultimate classic question/statement: "Is it a good idea to attend a patient's funeral?   We've been told by some folks not to attend a patient's funeral."  Answer: Yes, attend funerals or wakes, because it shows you care, and isn't that what medicine is supposed to be all about?!   Caring!

A great way to expose medical and nursing students as well as veteran clinicians to disclosure is with the Disclosure Documentary produced by Lawrence and Steve Kraman. The film is a terrific teaching tool -- available in a Grand Rounds version or a longer 1.5 hour version -- that will get students and staff talking and thinking about disclosure. To preview the film, e-mail newportclassic@gmail.com. Please include 1. the name of the organization, 2. your title/role and 3. Your e-mail address. There is no obligation to purchase.

I hope this column is shared with medical and nursing students and residents, and also veteran clinicians.    Have a great day.