Compassion and Detachment: Doctors Strive for Balance

“A Friend is the one who comes in when the whole world has gone out.”
–Anonymous

Some of my colleagues became remarkably close to a patient and family. As treatment progressed from surgery through radiation and chemotherapy, they allowed themselves to become increasingly involved. With cancer recurrence, they hurt; with deterioration, they grieved. When the patient died at home, one of the physicians was at the bedside. The patient, the family, and the team drew strength from each other. At least one physician wondered aloud if it had been a mistake to become so attached.

From early in training, physicians are mentored to be compassionate yet reserved. We strive to be appropriately detached from our patients. Each physician strikes this balance differently. How else could we get through bad outcomes? Could anyone deal with so much ongoing upheaval? Do families need the extra burden of a grieving physician?

Being completely detached satisfies no one. Being consumed leads to recurring anguish. However, being amenable to expanding friendships – a willingness to be open and available – enhances physician-patient interaction. “How is your family?” “Tell me about your trip.” “What is retirement like?” “Thanks for asking about my kids!” Often, we share more than is “required.”

When loss occurs, we will grieve. Yet, as Harold Ivan Smith points out, “grief for a friend is an inevitable consequence of taking friendship seriously.” Being open to friendship, if done ethically, can be rewarding. Everyone wins.

Bruce H. Campbell, MD, FACS
Interim Director
Froedtert & Medical College Cancer Center

"Reflections" is a collection of essays by the health professionals of the Medical College of Wisconsin.