Heartless?

As I alluded to in my most recent post, it's been a brutal week on my ward.  We've had a number of unexpected deaths and some devastating cancer diagnoses that have left the staff all feeling a bit emotionally raw.  Combine this with the fact that all of our residents are brand new doctors as of July first (i.e. inexperienced and uncertain of themselves), and the stress level on the ward is high.

During a venting session in the staff room, our charge nurse* took a very pragmatic approach to everything going on and said "What can you do?  You just get up and go back to work and get the job done."  To which another person, obviously reeling from some of the events of the week, snapped back "I can't just do that.  I have a heart!"

Which got me to thinking...is being practical and objective in medicine really being heartless?  Obviously it's important to be aware of how medicine and the things we do impact patients emotionally, but it's also important to make sure that orders get written and medications get administered and bedpans get emptied.  Perhaps we're having more of a heart sometimes when we're able to put aside our emotions and "get the job done" than we would be if we let our emotions overtake us.

In my earlier post about my dad, I talked about how hard emotionally it used to be for me to deal with the suffering of patients.  A year ago, if I'd had situations like I've had this week, I probably would've found myself struggling not to cry in front of patients and their families.  Now, I was able to talk to families about palliation and death without being nearly so affected by it.  I was able to offer some physical relief to patients, and hopefully some emotional comfort too - something I wouldn't have been able to do if I'd been fighting tears.  Am I heartless because I've learned how to detach somewhat?  Or am I doing my job, and doing it well?

When I started composing this post in my head (as I always do), I thought I had the answer to the question....and I think my post so far is coming out in support of objectivity as a tool to being a good doctor (or nurse or anyone else in health care).  But as I think about it more, I'm not sure how much one can be objective without it becoming a bad thing.  I don't ever want to be an automaton, delivering canned speeches to patients and their families while composing my grocery list in my head.  I want to find a way to retain some attachment to my patients, without becoming consumed by grief and without it keeping me from doing my job.  Is such a thing possible?

*I absolutely love our charge nurse, and I want to take her with me to every ward that I work on.  

On a happier and unrelated note, I have another weekend off!  It started off with dinner with great friends, which involved a lot of laughter and self-deprecating comments about how old we must be to want to go home to bed at 10 PM on a Friday.  I'm now sitting on my balcony, enjoying the absolutely perfect temperature and the sound of falling rain.  In the morning, I'm heading out of town to a local musical festival, where I'll spend most of my time in the kids' tent with my nieces (and hopefully get to hear a few of the adult performances).  On Sunday...who knows?  Likely sleeping.  And maybe I'll finally use my giant crop of basil to cook some food for myself.  Ahhhh....weekends make me happy.