A Doctor's Dilemma

Should we treat patients like our family — or treat our family like patients?

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Treat each patient as if they are your family. We hear this wisdom taught in medical school classrooms, whispered in ward corridors, and echoed in our own heads.

Rarely do we pause, however, to meditate upon what might happen if we were actually to treat each patient as a member of our own family…I remember when I was first taught this, in my first year of medical school, before I became a wife and a mother.

A certain calm, polished, calculated demeanor is the sign of a seasoned physician. While the casual outside observer might mistake this for simple callousness, this carefully sculpted approach to patient care is deeply multidimensional and allows the delivery of impeccable medical care. In pivotal moments, irrational emotions rarely result in productive therapy.

delimma 1The ability to calmly keep one’s own sense of sadness, grief, or even joy in careful check allows for the patient to be at the center of care. And while a doctor can deeply experience a range of emotions while caring for a patient, these feelings are carefully processed internally. Over the years of medical school and residency, we learn when it is appropriate and safe to cry with patients and when it is fitting to celebrate with them. Yes, we keep the patient at the center of our actions and reactions, but we are guided by reason, evidence, and years of training.

Emotional intelligence and disciplined control are ingrained in us, but our limits can be tested. What happens when the patient is literally a member of our family? What happens when the person before us is our parent, sibling, or child? Whether we’re asked for casual advice at the dinner table or to interpret a formal staging CT, we may all face a situation like this at some point in our career. Common sense warns us to simply avoid treating family. However, the lines we imagine should never be crossed are often blurred, bent, and traversed in real life. Perhaps the best approach we can take is to treat family as if they were our patients.

I have found myself navigating this uncharted territory between family and patient. I’ve come to realize that those two very precious titles are often not mutually exclusive.

In our work as radiologists, we wouldn’t allow irrational emotion to trigger a biopsy of a benign incidental finding on the very unlikely chance that a cancer is present. We don’t allow our judgment to be swayed to avoid a potentially painful but necessary procedure. We offer the best possible advice based on available evidence, within the context of each patient’s specific situation. We owe it to the people most dear to us, our families, to offer the same excellent care that we provide patients every day.

Can we approach the care of our loved ones with the calm, polished, calculated demeanor of a seasoned physician? Will we allow a family member’s experience to set the tone of the moment and appropriately curb our own emotional response? Will reason and experience guide our actions? Although quite difficult, in the pivotal moments of my family’s medical journey, treating my family as I would my patients is perhaps the most loving act I can offer.

As a daughter and a wife and a mother, who also happens to be a doctor, I know that the most selfless way I can provide excellent patient-centered care is by treating each person — family or not — with the same art of caring that I continue to sculpt on my journey through medicine.

hoqueKristina E. Hoque, MS, MD, PhD, is a neuroradiologist and nuclear medicine physician, practicing in Los Angeles.

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