“I prayed for you”
“I prayed every day you would have a healthy baby.”
She sat across the aisle from me at church you know,
Exchanged greetings of peace and watched my pregnant belly grow.
Tall in my white coat I stood before her in shivering snowflake gown.
My eyes and hands observed the tumor her right arm birthed had grown.
Too few weeks later I kneel beside her in her home hospice bed.
“I pray for you”
I silently said.
Words and tears are blocked by “professional boundaries” in my head.
I silently cried.
“I pray you have a peaceful death.”
Dr. Farah explores professional boundaries, prayer and expressing emotions with patients. As we have explored in other posts (Onime) dual relationships are common in rural areas. Our patients are our friends, and expect to be. We may see them at church and at the grocery store. Close relationships increase compassion, but may also bias us in our care for patients. Being close to a patient may make us more compassionate in giving bad news, but may make it harder to help a patient make decisions about their care because we have our own opinions and hopes as their friend. What have you seen on your rural rotations?
Dr. Farah also explores expressing emotions with patients. Crying with and for a patient is not a bad thing as long as we can step back and be in our doctor role when we need to be. The ability to move from one role to another is often called compartmentalizing. This allows us to switch between roles. For example, in a crisis, I need to put my feelings aside so I can think clearly and make decisions about what to do. Feeling sadness or happiness for and with patients is also quite human and shows that we care. Grieving the loss of a patient we were close to is normal and healthy. As a physician we are privileged to walk through the best and worst of times with patients. It is important to learn how to distance ourselves from some of the intense emotions, otherwise the roller-coaster ride of highs and lows is exhausting and draining. However, not taking the time to feel the feelings at all can lead to cynicism and burnout.