Doctors Struggle With Unrealistic Expectations And Lack Of Self-Care, Leading To A Lack Of Mercy Tow

“Mercy and consideration for the other man, but none for yourself, upon whom you have to keep an incessant watch.”
– Sir William Osler, MD.

Ironic, isn’t it? The physician is expected to go above and beyond, superhuman even, held to an unrealistic standard above most others, and yet, is their own worst critic. (Or was until social media, but that is another writing for another day.)

We continuously hold ourselves to that in nearly every aspect of life. Because we give so much to the job or calling, as some of us sentimentalists see it, there is not enough left to give adequately to those or those not involved in medicine. This sets us up to feel guilty and lacking in other aspects of our lives. After all, medicine is the utmost jealous mistress to all and refuses to be awarded anything but first place. It is a burnout no amount of yoga can fix. How can we reconcile this? I’m not entirely sure what the answer is, and I think many ponder the same.

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As a whole, we continue as teachers or mentors to snowball this inadequate amount of mercy to those below us in training or practice. For example, I remembered as clear as day at my first real clerkship as a third-year medical student nearly 15 years ago. All of the students had an idea of what specialty they had set their eyes on. Mine, at the time, was pediatric oncology. I even dreamed of working at Saint Jude’s Children’s Hospital. I did a six-week rotation at a children’s hospital, mostly on the oncology ward team. The attending at the time, a middle-aged MD who rarely smiled, was someone I referred to in my head as a “tough old bird.” I now know this was the attending’s coping mechanism. On the first day of table rounds, after all of us nervously presented patients and plans, a thick, palpable fog of despair hung in the air, especially after discussing the infant with relapsing acute leukemia.

The attending must have seen our hearts pounding on our sleeves, and though I did not personally see anyone shed a tear, they forcefully stated, “We do not cry here. The families do enough for everyone. If you are going to lose it, go into the damn stairwell, cry, collect yourself and wipe your face before returning.” Multiple gulps could be heard, followed by several emphatic nods.

Secretly, I cried every day when I returned to my vehicle and drove back to my apartment. This made certain for me that I could not do this for the rest of my life. I respected those that could, but I knew I would find it difficult to draw the line.

There is no, or certainly not enough, mercy in this profession — at least too few and far between. However infrequent, I have seen marvelous acts of mercy between colleagues, and I cling to those bright spots. One especially brought to mind centers around a selfless colleague, a kind and old soul who loves jazz and who has fallen on a sword for me more than once. You know who you are, my dear friend.

A good place to start is with more people like my friend. Let us all try to be that type of colleague and friend. Let us show mercy and consideration for our fellow MDs since we do a terrible job doing this for ourselves.

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