Anonymous Doctor

Three family meetings today.

I feel so distant right now, I think it's just three weeks of being on this service, where everyone is basically waiting to be sent home to die, I don't know, I walk in there and these family members are crying and in most cases haven't been prepared at all by their outpatient physicians as far as what the prognosis is... and I feel so powerless and ghoulish and so utterly removed from it emotionally.

One of our med students has grown close to one of the patients-- today was his last day in the hospital, he went in to say he wouldn't be on this team anymore... and he gave the patient his personal e-mail address in case he wants to stay in touch. And the patient mentioned it later, said that was so nice of the med student, and they really bonded.... On the one hand, I think it's great that the med student formed this nice relationship with the patient. On the other hand, I think it's probably a mistake and he's crossing some hard-to-articulate line. There's nothing bad about becoming friends with a patient. But I can see how this could go in some really unfortunate directions.

One problem is that the med student isn't this guy's doctor, and isn't yet a doctor at all. If the patient uses the e-mail address and asks a medical question, the med student shouldn't be in a position where it seems like he'd be speaking as this guy's doctor, or speaking on behalf of the team. He knows that-- but it seems like it would be way too easy to say something, casually, that could be misinterpreted as actual informed medical advice.

The other problem is that, emotionally, to get so invested... he's setting himself up to feel sad. And he'll feel sad anyway, but he's setting himself up to feel sadder. This job is sad enough. Why do anything to make yourself even sadder than you have to be?