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When a loved one is a patient: Navigating the emotional burden for physicians

Karen Leitner, MD
Physician
February 7, 2023
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It can be uniquely difficult as a physician when your loved one needs medical care, and you can’t help them in the way you would like.

Many feelings arise (failure, anger, anxiety, frustration) and the sense that you are letting them down.

As with anything, speaking about the commonality of an experience and normalizing it can help us generate self-compassion, a useful emotion that does not readily come to most physicians.

In my experience, three areas stand out as far as what limits us in helping care for a loved one:

Logistical

We don’t have access to the information we need. We don’t have their records. We can’t order tests. We (sometimes) cannot prescribe complex things. We live far away. We don’t have connections or authority inside the medical system they are being cared for inside. It becomes very difficult to help them navigate as compared to when it is our patient. We know the system and have collegial relationships and trust to rely upon.

Internal

Our medical judgment can be skewed with our loved ones. For those of us who have anxiety, this manifests as a lot of second-guessing. Do I or don’t I give my kid with croup the steroid? And then there is the paralyzing catastrophization.

We also worry about how we are perceived by the health care establishment. The stress of not wanting to act like “that” family member and finding the balance between advocacy and entitlement can feel like walking a tightrope.

When our child needs care, there is that extra sense of protectiveness. There are seemingly infinite ways to feel inadequate as a parent, giving our brain an opportunity to have a heyday. This, plus our heightened sympathetic nervous system response, can make it extra challenging to show up in the way we want.

Resistance

Sometimes people we love are resistant to our help. It can be hard for them to see us as the experts we are and not the little kid whose diaper they changed or the sister who stole their Halloween candy. Or sometimes, they want to do things their own way, which in patients we are more likely to accept, but in our loved ones, it is especially painful.

I remember once my mother had the flu, and I brought over an electrolyte drink, salty crackers, and acetaminophen and counseled her on the importance of fever control and hydration (all of which she ignored). Soon after, she fainted in the mailroom of her building and needed the paramedics called.

When this happens to a patient,  it is unfortunate, of course,  but when it happens to the family, the brain offers very painful thoughts: They should have listened to me. It could have gone so much differently. They could have avoided that (the delay in diagnosis, the wrong treatment from the specialist, the complication), so partly, this is my fault, and I failed.

If we zoom out a level or two, we can look at this differently. We get to offer ourselves self-compassion for how hard it is to be in this role of doctor, spouse, child, parent,  sibling, friend, etc. It is hard to have so much knowledge and not be able to use all of it to help those we care about most. It comes with the territory. It doesn’t mean anything about us. And we do make a difference even if it can’t be the same as it is with our patients.

The next time you are in this position, maybe try to offer yourself a little self-compassion.

This is hard. It comes with the job of being a physician. And you are not alone.

Karen Leitner is an internal medicine-pediatrics physician and life coach. She can be reached at her self-titled site, Karen Leitner MD.

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