Humanizing the Physician*

For the physician to remain sensitive to fatally ill patients, as represented by cancer patients, he would be required to remain aware of his own feelings about his own mortality and death, and of feelings of failure, hopelessness, depression, of anger, frustration, impotence, of disgust and revulsion, of indifference, impatience, of empathy and pity, of identification, of his need for closeness, need for affection, for love, for isolation, of his own dependency needs, of feelings of hatred, destructiveness and aggression—just to begin with. In fact, I mean that he must be aware of a fully orchestrated range of positive and negative, pleasurable and painful feelings. But many, if not most, physicians are unable to sustain this awareness and sensitivity.

There are many factors in shaping the feelings of physicians toward their patients, and perhaps most tend to produce the model of cold detachment which provokes widespread complaints from patients that doctors don't care about their patients. For just one example, the medical student in his preclinical years (this pattern is modified in many recent programs by earlier clinical exposure) has as his first model of medical demeanor the scientific detachment of