Last week I euthanized a patient in his back yard. This kind of experience always presents an emotional struggle but this one proved especially gut wrenching for a couple of reasons. A) The patient was a young cat dying of FIP. B) For the last two years my patient had served as an emotional service pet for a severely autistic boy.
Under such agonizing circumstances, who wouldn’t cry?
Veterinarians are like everyone else. We cry. We cry when our patients die unexpectedly. We cry when we euthanize beloved patients. We cry when we’re frustrated at our often vain attempts to heal our sickest patients.
In my case, I have a particular sensitivity to watching others cry –– children, especially. Nothing elicits tears like having to explain why Mom and Dad have decided Max should be euthanized. It's heartbreaking.
This should come as no surprise to most of you reading this. Most animal lovers can easily comprehend how any of the above scenarios might find us drowning in a puddle of saline solution.
Nonetheless, crying is still widely perceived as unprofessional in the allied health professions. Indeed, raw displays of emotion are considered a rarity in healthcare. Why else would this image of an ER doc (captured on film grieving the loss of a 19 year-old patient) go viral like it did?
Whether an ICU nurse, an ER doc, or a house call veterinarian, we’re all taught that our role is that of the dispassionate consultant, the self-possessed analyst, and the stoic bringer of critical healthcare news (mostly bad). When playing this part, it’s implicitly understood that any intense emotions need be stifled.
Emotions, it’s long been acknowledged, have the potential to impair our clinical judgment, interfere with the communication of crucial information, and ultimately detract from the quality of care we provide.
While undeniably chilly, this view makes sense. Suppressing raw emotions leaves room for rational analysis. But is it realistic?
Not only do I believe it’s unrealistic to expect a veterinarian to adopt a Vulcan attitude towards her patients, such stoicism is as unwanted by pet owners as it is impossible for many veterinarians. What’s more, I firmly believe this kind of dispassion is detrimental to clinical outcomes and patient care in general.
We humans have emotions for a reason. We crave empathy. We seek humanity in our workplace and among our healthcare professionals. And, if I can speak for my fellow healthcare workers, we do a better job when we’re emotionally engaged.
Yes, actually caring is fundamental to administering high quality healthcare. How else to recruit our clients’ best efforts in service of patients? How better to ratify their feelings than by emoting?
We all intuitively understand this. Yet our culture still draws a bright line when it comes to crying. Never mind that few people see as much suffering and heartbreak as we do, never mind that we too feel grief and sorrow and loss, shedding tears is effectively verboten in doctorly life.
We’re all different, though. Some of us can’t contain ourselves. For others among us, the culture of our workplaces also dictates our degree of public expressiveness.
For my part, given the intimate, family-style practice I’ve cultivated, displaying emotions in public is perfectly OK. That is, if it’s just a few loose tears we’re talking about (this happens about once every couple of weeks). Sometimes, however, conditions call for a good cry. Which I don’t do in public.
To hide this “unprofessional” pain, I’ve cried in bathrooms and corners and empty hallways. I’ve even left the hospital on a couple of occasions. (I’m sure my car has seen more impressive cries than most.)
I cry because, otherwise, this kind of caring work would eat me alive. Animal lives are as short and fragile as they are precious, which makes the heightened human emotions that accompany them especially difficult to deal with. If I didn’t have some emotional outlet for them, I’d probably have a lot more scars to show for it. And while scars may be a badge of honor, they make us tough. And toughness isn’t always what’s best in a healthcare professional.
Ultimately, this line of thinking finds me agreeing with those who believe we need to change our communally entrenched mindset on this issue. Crying is not unprofessional in veterinary medicine. In fact, it should be well-understood that veterinarians and their staff cry –– sometimes a lot.
What’s tricky, however, is that while crying should theoretically be considered part of our profession, and even encouraged as an outlet for our emotions, hospital manager types urge caution: Crying shouldn’t be disruptive. (If at all possible.) It should be courteous and respectful. (If at all possible.) And that’s a fine line to walk.
Crying gets a bad name precisely because it has a way of being utterly inconvenient, often uncomfortable, and mostly messy. Hospital managers hate this kind of thing. And I get it. But let’s be honest, does crying ever hurt anyone? Sure, it’s awkward. But managers would do well to remember this:
Being willing to cry not only channels all those otherwise pent-up emotions, sharing our pain it helps us bond with our clients and patients, too. In fact, I tend to think our clients like us better because we’re willing to be vulnerable in public, because we’re willing to grieve with them, and because it shows we’re human just like them.
Socialized as we’ve been to hide our least controllable emotions, most of us will probably still keep our outbursts to ourselves (men especially, but also women who’ve been taught that mimicking male behavior is a sound practice). Some of us are holding back because that’s what’s expected of us but a percentage of us is just private that way. In fact, many among us will probably never cry in public.
Which is fine. No two people grieve in the exact same way. Nor should anyone ever feel pressured to shed tears (that would be creepy). Rather, what I’m suggesting is that we collectively dispense with the notion that professional doctors don’t cry. Because –– guess what? –– real doctors do. Whether you see them at it or not.
- Dr. Patty Khuly