I was easily inclined to like Ofri: she draws upon her experience practicing at Bellevue Hospital (New York City's enormous charity facility) among Spanish-speaking patients. Many years ago, I collected all too much experience transporting and assisting indigent and desperate residents of the then-impoverished Lower East Side to the very ER where she learned medicine. I was a patient there myself at least once. The docs always seemed to do the best they could -- respectfully at that -- amid the chaos.
Ofri is at her most interesting when she tries to discern what it is about the training of doctors that measurably encourages newly minted professionals to shut down their own feelings in response to their patients' troubles. Stress, insane work hours, heavy responsibility, and the need to slough off repeated exposure to ugly human realities are obvious factors. She cites studies of the nature of empathy and reports a definition I find clarifying:
She describes a pilot program in which inexperienced medical personnel discussed feelings so as to learn to use the empathy they felt for patients' benefit without succumbing to overload and cynicism. She evaluates it as has having some success.
Her topics include what doctors do with the grief that conscientious ones feel when patients die. Here's Ofri describing her own feelings about forming new medical relationships after the death of a sympathetic long time patient.
Attractive and self-revealing as Dr. Ofri's descriptions of her own feelings make her, I was surprised by how little I could sympathize with her distress about being sued by former patients, something that she documents that 99 percent of doctors will experience during their careers. I just can't be surprised that this happens, even to very good doctors. Patients feel so little power in their relationships with the medical profession that it is almost inevitable that some will turn to the courts to reassert their autonomy, even if they don't have a case. Ofri says most of these lawsuits eventually go away without judgement. But she complains:
I can only attribute what I read as the doctors' exaggerated whining in response to litigious patients (and families) as evidence that they just don't get it: as patients, we're scared, feel helpless, and profoundly disempowered. Some of us, if we have the chance -- if our maladies don't kill us or leave us witless -- will strike out at the available authority. We will strike out at the very people who saved our lives.
If doctors hadn't cauterized their human feelings, they might understand that. Not a good state of affairs all around, but there it is.