Can doctors really learn from having an illness themselves?

Once upon a time, I was a lifeguard.  This was the natural result of swimming fairly well, Red Cross training, and team competition.  I saw myself as a handsome, tanned guardian at the ready.  OK, I was prone to self-delusion.  When I became a doctor I carried over that image of high-perched protector on stilt chair, whistle in hand, rescue float close, ready to dive to the assistance of a drowning patient.  I was wrong.

The critical difference between a lifeguard and a doctor is intimacy of involvement.   A lifeguard must able to navigate in the water.  Not many of us would be happy that the bronze babe standing watch could not actually swim.  “Do not worry, I have read all the research on hypothermia, rip tides and CPR,” would not reassure us, if she could not float.  A lifeguard saves by directly applying a skill that at the moment of crisis, the bather lacks; when we cannot, they can.

Not so a doctor.  A physician does not need to be sick, nor have any special skill at keeping themselves healthy.  They can be a robust Adonis of perfect form, or a chain-smoking, obese creature with diabetes, hypertension and an arthritic gimp.  We do not depend on the health of the doctor’s body, nor the emotional stillness of their soul, in order to regain our own vitality.

Strangely, we do desire that our doctor take as good of care of himself as he demands of each of us.  If he is a sedentary 250 pounds, we do not take seriously the prescription to diet and exercise.   We will likely ignore a quit-smoking demand from a doc with yellowed fingers. However, is it relevant?  If you are consumed by a complex medical crisis with discomfort, debilitation and radical life change, do you really care if your doctor is eating soy or steak?  There is no comfort in the words, “Well, I have no idea how to treat that cancer, but amazingly I have had it myself.”

Much has been written about how being sick changed a healer’s perspective on disease, suffering and medical practice.  Many times, I have heard, “The best teaching for a doctor is to have an illness themselves.”  I wonder.  While there are valuable lessons learned dealing with rude staff, onerous insurance companies, the struggle to recover and unremitting pain, do those experiences really enhance one’s compassionate radar?  A doctor beaten down by disease may be emotionally and physically frail, and may project their own suffering onto the condition of each patient, even if not relevant.

We want lifeguards to be intimately involved with us in our struggle against consuming waters.  There is no role for objectivity in those frantic moments before we slip under.  For God’s sake, dive in.  Doctors, not so much.  We depend on physicians in their decisions, teaching and guidance to be objective and analytical, science and data based.  Misery does not wish professional company.  Their skill and wisdom must come from a point well above the waves.  That distance does not mean physicians do not care. Their compassion is based not in their personal health or goals, but in shared humanity, love of life and abhorrence of suffering.  The great art of medicine is that doctors can save without ever needing to swim.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

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  • James O’Brien, M.D.

    My recent illness taught my high tech medicine is overrated and the good old fashioned H and P is a lost art.

  • Lisa

    When I sprained my thumb, I was sent to see a hand specialist, to be evaluated for surgery. The hand specialist recommended against it, but was able to tell me what to expect in terms of recovery and how to rehab my thumb. I loved the fact that he had dealt with the same injury and knew from personal experience what he was talking about.

    I see a rheumatologist occasionally for the OA in my hands. The last time I saw him my thumbs were triggering (very painful) and he recommended a cortosone injection. He sold me when he told me that he has the same problem and has given himself injections. He also had some great advice for living with OA, valuable beyond any medication he or my pcp would have prescribed.

    In those instances, seeing a doctor who had the same problem was helpful to me. But those instances were unusual. I think the OP is right, the skill and the ability of a doctor is not dependent on his medical history.

  • John C. Key MD

    I have learned so much from my illnesses both surgical and medical. I share often with patients, which some advise against but I find it helpful and patients seem to like it.

    • Kristy Sokoloski

      On the one hand I can understand why some advise against sharing your own personal experiences, but on the other hand I think they are wrong. Like you I find it helpful and the reason is because not so much because I as a patient like it but moreso it helps me remember that doctors are human too even though I am so used to seeing them in the professional setting. That’s why like I have said multiple times in other posts including in reply to one of Dr. Pamela’s last posts that I make an effort not only to tell them thank you for what they do for me, but to also ask them how they are doing. You all have good days and bad days just like me and that’s both on the illness front and on the general front. Knowing both of these factors if done appropriately can help the bond between patient and physician get stronger, stronger in a way that most would not understand unless they are in the situation themselves.

  • Eric Strong

    The most valuable afternoon I ever spent in regards to my medical training was when I showed up at a well respected urgent care clinic with an acute complaint, and intentionally didn’t tell anyone that I was a doctor myself. The list of things done incorrectly during the visit were so numerous (e.g. poor interview technique, negligible exam, bogus management recommendations based on pseudoscience, and fraudulent documentation – which I checked later), it made me question how an ill layperson survives a trip through the health care system.

    In addition to making me more empathetic towards patients struggling through the system, it’s made me even more skeptical of the work-up and diagnoses that patients carry with them when I first meet them.

    • Suzi Q 38

      A friend of mine is married to a physician.
      She told me that she has never had any problems.
      I asked her if she told physicians, clinics, and hospitals that she was married, to Dr. A, the pulmonary specialist?
      She said that she always does, because she has to.
      I told her “No you don’t. Why don’t you just be a nobody like us for once?”

      This is why she gets good care. She makes sure to let the doctors know that she is married to a doctor…..

      • Eric Strong

        That’s absolutely true that doctors (and close relatives of doctors) get different care than other patients.

        The one time in my life I’ve been hospitalized (after a serious accident), the ER apparently knew before I arrived that I was a physician. I had the chief of trauma surgery and ortho checking in on me routinely (and no, they weren’t on service). I don’t know why health care professionals treat our own kind so much differently than the rest of the population – if it’s because they truly want to give better care out of loyalty to their brethren, or if they know they can’t get away with the bull they put other patients through.

        Interestingly though, at least as far as hospitalized patients, I’m not convinced that physician-patients and other “VIPs” actually end up with better care because of the increased attention. In my experience, they are more likely to undergo excessive testing, nurses and residents feel less comfortable examining them (and thus don’t pick up on acute changes in condition as quickly), and they often aren’t provided acceptable counselling (e.g. dietary advice, substance abuse counselling, explanation of risk/benefits of proposed procedures) because everyone incorrectly assumes they know it all already.

    • James O’Brien, M.D.

      So no full H&P and review of systems, like we were taught in second year of medical school?

      • Eric Strong

        If he had been my medical student and performed that “H&P”, I would have given him a failing grade without hesitation.

  • buzzkillerjsmith

    My illnesses have taught me that benzodiazepines, opioids, and the newer antipsychotics should really be used more often.

  • http://www.thepatientdoc.com The Patient Doc

    Living with lupus has helped me become a better physician. It’s opened my eyes to everything a patient goes through, such as the anxiety of waiting for test results, or how an extra medication can make life miserable. How another test or doc’s appt means missing another day of work, or how an hour in a waiting room when you are sick or in pain can feel like ages. I’ve always had compassion but now I have understanding and true empathy. Also I do not feel that I am emotionally frail, and do not feel like I place my misery or suffering on patients, as I don’t feel miserable.

  • Karen Ronk

    This is so relevant to a recent experience of mine with a doctor I visited hoping to get answers to a complicated medical issue. He went off on tangents about his own health ailments/conditions so many times that I could no longer even follow where he was going. It was a very disappointing and ultimately useless consultation. Doctors are human and in the right circumstances it is perfectly okay to mention related health issues in passing, but they should never overshadow the patient’s concerns.

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