Reversing prosopagnosia part II

First, I need to thank all the readers of my blog. I love to write, and receiving feedback from friends and co-residents feels good. I appreciate your support on my journey as a writer. Today’s post responds to a question from one of my best friends, someone I greatly respect. His question to my post was: “Isn’t the lack of empathy also a way to cope with the horrible things you see as a doctor every day? Caring about patients like you are their parents would make you go crazy.”

I have given a lot of thought to this question. One of the reasons why I chose general pediatrics is because I don’t cope well with dying or suffering children. The more specialized you are in medicine, the higher your chances of encountering very sick children. However, I don’t believe specialized pediatricians are insensitive or lack empathy. A pediatrician in palliative care or oncology can be caring and empathetic with a dying patient; on the other hand, a general pediatrician who only conducts well-child visits can approach a patient as if they were a machine or puzzle to be solved.

As with almost everything in life, the problem is the lack of equilibrium. Just because we need to be analytical and objective about the signs and symptoms of an illness, we should forget our patients’ humanity. Caring too much can cloud our judgment, which is why treating family members is unethical; it can also lead to compassion fatigue, a state of indifference, pessimism, and overall disinterest in other people’s issues. Conversely, treating a person as an object devoid of feelings is wrong. Both extremes can harm our patients. The world needs pediatricians who can be objective and care about their patients.

It is not wrong to have discussions like “the morning report” or “interesting case of the month.” Nevertheless, we also need to discuss about how to treat our patients with empathy and love. I have read about pneumonia, vaccines, and developmental milestones about 50-100 times (especially the milestones). We tend to forget if we don’t read again. However, I must admit that until recently, I had not read much about caring in medicine. We assume that because we are in medicine, we care. That is not always true. We hear hundreds of stories from people, even friends or family, have complained about how insensitive their doctor was. I wonder how that happens; I have feared becoming the doctor people complain about.

We need reminders; we need to take time to reflect and read about this. Books like “Better” by Atul Gawande or “The Heart of Care” by Mark Vonnegut can be a starting point. Maybe even as you read this blog, you can take a moment to reflect. Reversing prosopagnosia in medicine requires daily effort and, like a chronic illness, requires ongoing “treatment” for as long as we practice medicine.

Please feel free to share your ideas or recommend books in the comments that can help reverse prosopagnosia in medicine.

Dedicated to my friend Lennart Z.