When I was first interviewing oncologists to decide whom to put on my team to help me deal with my prostate cancer recurrence, I remember leaving the office of the doctor I eventually selected and saying to my wife, “I can’t use him.” She asked why and I replied, “He is not going to be emotionally available to hold my hand when I lie dying in a hospital bed.”
She replied that should not be his job, it was her job. She pointed out that I was hiring a doctor for his knowledge, skill and artistic abilities, not for his handing holding ability or his tears. I thought about her comments, greatly appreciated her willingness to be my hand holder, and decided she was correct.
I decided that I do not necessarily need my doctors or nurses to hold my hand (although that might be nice) or cry with me at my bedside, (again, at times I might not mind that either). Therefore, I decided to “go” with this doctor and work to develop a connection that goes beyond his normal distanced stance. I will continue to develop this relationship and gently teach him to become at least a little empathic.
Empathy and the Practice of Medicine: Beyond Pills and the Scalpel, edited by Howard Spiro, MD has in its introduction as very interesting comment, “Disease, which is what diagnostic equipment displays, needs science for cure, whereas illness, the patient’s suffering, needs the physician for care.”
Many doctors have been trained to believe that there is no room for emotion in medicine, because emotions cloud judgment and get in the way of sound clinical decision-making. I disagree with this blanket statement. At times emotion and empathy should be a part of a doctor-patient relationship.
When caregivers, including doctors, demonstrate empathy, good clinical things do happen.
When dealing with an empathic caregiver, patients will be more forthcoming about their symptoms and concerns. Often, this additional information will pave the way for a better diagnosis and better treatment.
If doctors are better able to understand their patients, including those issues that will motivate a patient to partake in a prescribed therapy, compliance rates will increase.
Although I have never seen anything written supporting this theory, I believe that just as a placebo can have a significant positive effect on a person’s health; empathy too might provide a positive placebo effect for an ill patient.
I still hold out hopes of teaching him the value of empathy, but in the mean time, I am taking full advantage of his phenomenal knowledge about advanced prostate cancer.
Joel T Nowak MA, MSW
I want to share with you a recent visit with my doctor. I had been having more problems with back pain more than usual,(fighting advanced prostate cancer for the last three years). When I told him, he laughed and told me to deal with it. I have never been so mad or upset as I was that day. He is the only urologist within 50 miles. I am debating whether or not to change doctors at this stage when the hormone treatment is failing and my PSA is rising. Any advice for me?
You can not move to a new doctor fast enough! Move tour care to a medical oncologist who treats many men with advanced prostate cancer instead of another urologist. Finding a new doctor yesterday is not fast enough. -Joel