Bringing Humanity Back to Medicine: A Book Review of " Attending " by Ronald Epstein

by Lyle FettigWhen debriefing after a difficult communication encounter led by a fellow or resident, I ’ll often start by asking the trainee, “how do you think it went?” There are times when I thought the encounter went very well, yet the trainee leaves the room with a worried look. Perhaps the trainee clearly explained the medical facts, demonstrated ample empathy, and carefully talked about t he next steps, so I’ll be a bit surprised when the trainee says, “It went horrible.” I’ll ask why, and I’ll get a bemused look in response. “Because I made the patient cry,” the trainee might say. Usually, when this happens, the trainee knows that it was the serious news that made the patient cry: A change in condition, a revelation about prognosis, etc. Deliberate reflection on skillful communication requires some understanding that while patients may respond differently to various communication techniques, we are ultimately not responsible for the patient’s emotional response to serious information. Even if giving the information was the ethical and pragmatic way to proceed, the physician is at risk for experiencing strong emotions that mirror those of the patient’s. The response of the patient and the physician’s experience of observing the response might make some second guess whether they have approached the conversation skillfully, even when they have.“Attending: Medicine, Mindfulness, and Humanity” by Dr. Ronald Epstein, professor of family medicine...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: book depression fettig humanity media mindfulness review The profession Source Type: blogs