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To Cry or Not to Cry? That’s the Question
To Cry or Not to Cry? That is the Question
“Those who do not weep, do not see.”
~ Victor Hugo, Les Misérables
I entered medical school at age 20, and now I am over 70 years old. In that span of over half a century, I have never, ever seen a doctor cry. I have never heard a doctor talk about feeling like crying. It never occurred to me to ask, “How I should handle such feelings?” Instead, I wanted to hide my feelings and pretend I did not have them. I was ashamed. I thought there was something wrong with me that I had such feelings in my role as a professional. I saw myself as less than, as inferior, defective for even having such feelings.
As an intern assigned to pediatrics, I attended children who had terminal illnesses. I recall watching the life drain out of a boy undergoing treatment for leukemia. On nights that I was not on call, I would get down on my knees before getting into bed and pray (something that I did not routinely do, or more accurately rarely did). I pleaded to God to let the boy die that night when I was not on call. Why? I was afraid. If he died on my watch and I had to pronounce him dead and interact with his parents, I knew I would tear up, perhaps lose my voice, or even breakdown and cry. Well, thank God, he did die on a night that I was off. However, thereafter, I was still in a quandary. What was I to do to acknowledge his passing? I knew I could not talk in person to his parents because, again, I might cry. I decided to write his parents a letter of condolence. In the wake of his death, none of my coworkers (including me) talked about him or how to express ourselves to the family. There was no discussion of our feelings of sadness and loss and how to respond. Could we do things that ordinary human beings do, like go to his funeral service, or send a card, or send flowers?
The boy passed, his room was cleaned, and we were onto our next patient—business as usual. In saying this, I don’t want to imply that he was not treated by the physicians and staff in a caring way because they did. But, discussion of feelings was an unspoken taboo. Physician feelings of sadness, grief, and morning were taboo topics, as if such feelings didn’t exist. How did this experience affect me? Previously, I had considered pediatrics as a field of specialization. I like children. However, given my emotional make up, I decided that I could not become a pediatrician. I did not fit into the culture of my colleagues. Obviously, I was not emotionally strong enough.
Over subsequent years, on my own, I developed a different perspective. About a year after entering practice as a veterinarian, my daughter called me on the phone one night and said: “Dad, I am in trouble. I might lose my job.” She had been the vet for a family whose pet dog eventually had to be euthanized. At a final gathering, the two young children were overcome with grief. In response, she hugged them, and then she teared up. She told me that as students, she and her classmates had been explicitly told not to show such emotions. I responded: “People know instinctively when you are crying for yourself and when you are crying for them. If your colleagues can’t see that, they don’t deserve to have you.” The comforting words of a father were not enough to erase the fear.
Of course, neither the family nor the support staff registered a complaint against her. On the contrary, a month later, a large bouquet of flowers arrived at the clinic with a card addressed to her thanking her for “caring” and requesting that, when they were ready to adopt a new pet, they wanted her to help them in the selection. The staff placed the bouquet with the card on the office reception counter for all to see.
Yes, as professionals, we have to exercise some restraint over our emotions. But, our patients know the difference between crying for them and self-indulgence on our part. Sometimes, especially when there is nothing else we can offer, they just need our compassion.
Think about it: “To cry or not to cry? What kind of doctor do you want to be?”
By Norman T. Reynolds, MD Distinguished Life Fellow of the American Psychiatric Association
~ Elizabeth Gilbert, Eat, Pray, Love
