{"product_id":"what-doctors-feel-isbn-9780807033302","title":"What Doctors Feel","description":"\u003cb\u003e“A fascinating journey into the heart and mind of a physician” that explores the doctor-patient relationship, the flaws in our health care system, and how doctors’ emotions impact medical care (\u003ci\u003eBoston Globe\u003c\/i\u003e)\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003eWhile much has been written about the minds and methods of the medical professionals who save our lives, precious little has been said about their emotions. Physicians are assumed to be objective, rational beings, easily able to detach as they guide patients and families through some of life’s most challenging moments. But understanding doctors’ emotional responses to the life-and-death dramas of everyday practice can make all the difference on giving and getting the best medical care.\u003cbr\u003e \u003cbr\u003eDigging deep into the lives of doctors, Dr. Danielle Ofri examines the daunting range of emotions—shame, anger, empathy, frustration, hope, pride, occasionally despair, and sometimes even love—that permeate the contemporary doctor-patient connection. Drawing on scientific studies, including some surprising research, Dr. Ofri offers up an unflinching look at the impact of emotions on health care.\u003cbr\u003e \u003cbr\u003eDr. Ofri takes us into the swirling heart of patient care, telling stories of caregivers caught up and occasionally torn down by the whirlwind life of doctoring. She admits to the humiliation of an error that nearly killed one of her patients. She mourns when a beloved patient is denied a heart transplant. She tells the riveting stories of an intern traumatized when she is forced to let a newborn die in her arms, and of a doctor whose daily glass of wine to handle the frustrations of the ER escalates into a destructive addiction. Ofri also reveals that doctors cope through gallows humor, find hope in impossible situations, and surrender to ecstatic happiness when they triumph over illness.Intoduction: Why Doctors Act That Way\u003cbr\u003e\u003cbr\u003eChapter 1: The Doctor Can't See You Now\u003cbr\u003e\u003ci\u003e Julia, part one\u003c\/i\u003e \u003cbr\u003eChapter 2: We Build a Better Doctor?\u003cbr\u003e \u003ci\u003eJulia, part two\u003cbr\u003e\u003c\/i\u003eChapter 3: Scared Witless\u003cbr\u003e \u003ci\u003eJulia, part three\u003cbr\u003e\u003c\/i\u003eChapter 4: A Daily Dose of Death\u003cbr\u003e \u003ci\u003eJulia, part four\u003cbr\u003e\u003c\/i\u003eChapter 5: Burning with Shame\u003cbr\u003e \u003ci\u003eJulia, part five\u003cbr\u003e\u003c\/i\u003eChapter 6: Drowning\u003cbr\u003e \u003ci\u003eJulia, part six\u003cbr\u003e\u003c\/i\u003eChapter 7: Under the Microscope \u003cbr\u003e \u003ci\u003eJulia, part seven\u003cbr\u003e\u003c\/i\u003e\u003cbr\u003eAfterword\u003cbr\u003eAcknowledgments\u003cbr\u003eNotes\u003cbr\u003eIndex“Taut, vivid prose . . . She writes for a lay audience with a practiced hand.”\u003cbr\u003e\u003cb\u003e—\u003c\/b\u003e\u003ci\u003e\u003cb\u003eNew York Times\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e\u003c\/i\u003e“In her lucid and passionate explanations of the important role that emotions play in the practice of medicine and in healing and health, Danielle Ofri tells stories of great importance to both doctors and patients.”\u003cbr\u003e\u003cb\u003e—Perri Klass, author of \u003ci\u003eTreatment Kind and Fair \u003c\/i\u003e\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e “An invaluable guide for doctors and patients.”\u003cbr\u003e\u003cb\u003e—\u003ci\u003eKirkus Reviews\u003c\/i\u003e\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e“Insightful and invigorating…makes the case that it’s better for patients if a physician’s emotional compass-needle points in a positive direction.”\u003cbr\u003e\u003cb\u003e—\u003ci\u003eBooklist\u003c\/i\u003e, starred review\u003c\/b\u003e \u003cbr\u003e\u003cbr\u003e“A fascinating journey into the heart and mind of a physician struggling to do the best for her patients while navigating an imperfect health care system.”\u003cbr\u003e\u003cb\u003e—\u003ci\u003eBoston Globe\u003cbr\u003e \u003c\/i\u003e\u003c\/b\u003e\u003cbr\u003e “Ofri gives voice and color to the heartbreak, stress, and joy that attends medical practice.”\u003cbr\u003e\u003cb\u003e—\u003ci\u003eLibrary Journal\u003c\/i\u003e\u003c\/b\u003e \u003cbr\u003e\u003cbr\u003e “A fabulous read.”\u003cbr\u003e\u003cb\u003e—\u003ci\u003eGreater Good\u003c\/i\u003e\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e“Essential reading in Medical HumanitiesShe weaves together personal anecdotes and medical learning in a compelling account of her medical decisions and reflections. Highly recommended.”\u003cbr\u003e\u003cb\u003e—Sara van den Berg, Professor of English, Saint Louis University\u003c\/b\u003e\u003ci\u003e\u003cbr\u003e\u003cbr\u003e\u003c\/i\u003e“Dr. Ofri's real-life experiences can be incorporated into a variety of health science curricula bringing course theory together with practical application. Readers gain critical insight into why applying theory in the practice of medicine requires empathy for the physicians.”\u003cbr\u003e\u003cb\u003e—Christine Whittrock, Department of Pharmaceutical Sciences, Temple University\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e“Part of medical education now is not only core competencies from a factual standpoint but also a social standpoint. Dr. Ofri has a way of communicating those lessons in a clear a cogent and very personal fashion.”\u003cbr\u003e\u003cb\u003e—Beth Dollinger M.D., Arnot Ogden Medical Center\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003e “\u003ci\u003eThe\u003c\/i\u003e perfect book for my teaching on the subject of lack of empathy in medical school students.”\u003cbr\u003e\u003cb\u003e—James Asa Shield, Jr., MD, Professor, Chairman, Department of Psychiatry, Virginia Commonwealth University\u003c\/b\u003e\u003cb\u003eDanielle Ofri\u003c\/b\u003e, MD, PhD, is an associate professor of medicine at the New York University School of Medicine and has cared for patients at New York’s Bellevue Hospital for more than two decades. Ofri’s books and articles have become academic staples in medical schools, universities and residency programs. She is the editor in chief of the \u003ci\u003eBellevue Literary Review\u003c\/i\u003e and writes regularly for the \u003ci\u003eNew York Times\u003c\/i\u003e.\u003cb\u003eIntroduction\u003cbr\u003e\u003cbr\u003eWhy Doctors Act That Way\u003c\/b\u003e\u003cbr\u003e\u003cbr\u003eThe experiences of medical training and the hospital world have been extensively documented in books, television, and film. Some of this has been probing and incisive, and some has been entertaining nonsense.\u003cbr\u003e\u003cbr\u003e Much has been written about what doctors do and how they frame their thoughts. But the emotional side of medicine—the parts that are less rational, less amenable to systematic intervention—has not been examined as thoroughly, yet it may be at least as important.\u003cbr\u003e\u003cbr\u003e The public remains both fascinated and anxious about the medical world—a world with which everyone must eventually interact. Within this fascination is a frustration that the health-care system does not function as ideally as people would like. Despite societal pressures, legislative reforms, and legal wrangling, doctors don’t always live up to these ideals. I hope to delve beneath the cerebral side of medicine to see what actually makes MDs tick.\u003cbr\u003e\u003cbr\u003e One might reasonably say, \u003ci\u003eI don’t give a damn how my doctor feels as long as she gets me better. \u003c\/i\u003eIn straightforward medical cases, this line of\u003ci\u003e \u003c\/i\u003ethinking is probably valid. Doctors who are angry, nervous, jealous,\u003ci\u003e \u003c\/i\u003eburned out, terrified, or ashamed can usually still treat bronchitis or\u003ci\u003e \u003c\/i\u003eankle sprains competently.\u003cbr\u003e\u003cbr\u003e The problems arise when clinical situations are convoluted, unyielding, or overlaid with unexpected complications, medical errors, or psychological components. This is where factors other than clinical competency come into play.\u003cbr\u003e\u003cbr\u003e At this juncture in our society’s history, nearly every patient—at least those in the developed world—can have access to the same fund of medical knowledge that doctors work from. Anyone can search WebMD for basic information or PubMed for the latest research. Medical textbooks and journals are available online. The relevant issue— the one that has the practical impact on the patient—is how doctors \u003ci\u003euse \u003c\/i\u003ethat knowledge.\u003cbr\u003e\u003cbr\u003e There has been a steady stream of research into how doctors think. In his insightful and practically titled book \u003ci\u003eHow Doctors\u003c\/i\u003e \u003ci\u003eThink, \u003c\/i\u003eJerome Groopman explored the various styles and strategies that doctors use to guide diagnosis and treatment, pointing out the flaws and strengths along the way. He studied the cognitive processes that doctors use and observed that emotions can strongly influence these thought patterns, sometimes in ways that gravely damage our patients. “Most [medical] errors are mistakes in thinking,” Groopman writes. “And part of what causes these cognitive errors is our inner feelings, feelings we do not readily admit to and often don’t even recognize.”1\u003cbr\u003e\u003cbr\u003e Research bears this out. Positive emotions tend to be associated with a more global view of a situation (“the forest”) and more flexibility in problem solving. Negative emotions tend to diminish the importance of the bigger picture in favor of the smaller details (“the trees”). In cognitive psychology studies, subjects with negative emotions are more prone to anchoring bias—that is, latching on to a single detail at the expense of others. Anchoring bias is a potent source of diagnostic error, causing doctors to stick with an initial impression and avoid considering conflicting data. Subjects with positive emotions are also prone to bias; they are more likely to succumb to attribution bias. In medicine, this is the tendency to attribute a disease to who the patient is (a drug user, say) rather than what the situation is (exposure to bacteria, for example).\u003cbr\u003e\u003cbr\u003e This is not to say that positive emotions are better or worse than negative emotions—both are part of the normal human spectrum. But if you consider the range of cognitive territory that doctors traverse with their patients—genetic testing, ordinary screenings, invasive procedures, ICU monitoring, and end-of-life decisions—you can appreciate how the final outcomes can be strongly influenced by a doctor’s emotional state.\u003cbr\u003e\u003cbr\u003e Neuroscientist Antonio Damasio describes emotions as the “continuous musical line of our minds, the unstoppable humming.”3 This basso continuo thrums along while doctors make a steady stream of conscious medical decisions. How this underlying bass line affects our actions as doctors—and the net effect on our patients (and on doctors when we ourselves become patients!)—is what intrigues me.\u003cbr\u003e\u003cbr\u003e By now, even the most hard-core, old-school doctors recognize that emotions are present in medicine at every level, but typically this is lumped in with the catch-all of stress or fatigue, with the unspoken assumption that with enough self-discipline, physicians can corral and master these irritants.\u003cbr\u003e\u003cbr\u003e The emotional layers in medicine, however, are far more nuanced and pervasive than we may like to believe. In fact, they can often be the dominant players in medical decision-making, handily overshadowing evidenced-based medicine, clinical algorithms, quality control measures, even medical experience. And this can occur without anyone’s conscious awareness.\u003cbr\u003e\u003cbr\u003e It could easily be argued that doctors are no more emotionally complex than accountants, plumbers, or the cable-repair guy, but the net result of doctors’ behavior—logical, emotional, irrational, or otherwise— can have life-and-death consequences for patients, which is to say, for all of us.\u003cbr\u003e\u003cbr\u003e We all want excellent medical care for ourselves and our families, and we’d like to assume that the best care comes from the doctors with the best training, or the most experience, or the best \u003ci\u003eU.S. News\u003c\/i\u003e \u003ci\u003e\u0026amp; World Report \u003c\/i\u003erating. However, the myriad effects of emotional underpinnings can confound all of these factors.\u003cbr\u003e\u003cbr\u003e Despite this, the conventional stereotype that doctors are fairly emotionless continues to maintain its hold. Many trace this back to the eminent Canadian physician Sir William Osler, often considered the father of modern medicine for such revolutionary ideas as whisking medical students out of the staid classroom and bringing them to the bedside to learn medicine by examining actual patients. The current educational system of clinical clerkships and residency training is largely attributed to Osler, as are hundreds of snappy quotations. His continuing influence is apparent in the scores of diseases, endless libraries, and numerous medical buildings, hospital wings, societies, and awards that bear his name.\u003cbr\u003e\u003cbr\u003e On May 1, 1889, Dr. Osler stood before the graduating medical class at the University of Pennsylvania and delivered a valedictory— and now canonical—speech entitled “Aequanimitas.”4 He stressed to these fledgling doctors that “a certain measure of insensibility is not only an advantage, but a positive necessity in the exercise of a calm judgment.”\u003cbr\u003e\u003cbr\u003e While Osler may not have created these attitudes, he neatly encapsulated the general feeling about how doctors should behave.\u003cbr\u003e\u003cbr\u003e Though he did warn against “hardening the human heart,” the stereotype of the detached, coolheaded physician springs from this idea of equanimity.\u003cbr\u003e\u003cbr\u003e Popular culture has embodied this. Television doctors from Ben Casey to Gregory House are detached from their patients, lauded for their technological and diagnostic acumen. Even the selflessly idealist doctors (in \u003ci\u003eArrowsmith\u003c\/i\u003e, \u003ci\u003eMiddlemarch\u003c\/i\u003e, and \u003ci\u003eCutting for Stone\u003c\/i\u003e) and the bitingly sarcastic doctors (in \u003ci\u003eM*A*S*H\u003c\/i\u003e, \u003ci\u003eHouse of God\u003c\/i\u003e, and \u003ci\u003eScrubs\u003c\/i\u003e) maintain an equanimitous distance from their patients.\u003cbr\u003e\u003cbr\u003e Every hospital dutifully includes the word \u003ci\u003ecompassion \u003c\/i\u003esomewhere in its mission statement. Every medical school rhapsodizes about the ideals of caring. But the often unspoken (and sometimes spoken) message in the real-life trenches of medical training is that doctors shouldn’t get too emotionally involved with their patients. Emotions cloud judgment, students are told. Any component of a curriculum upon which interns slap the “touchy-feely” label is doomed in terms of attendance. Hyperefficient, technically savvy medical care is still prized over all else.\u003cbr\u003e\u003cbr\u003e But no matter how it’s portrayed, and no matter how many high-tech tools enter the picture, the doctor-patient interaction is still primarily a human one. And when humans connect, emotions by necessity weave an underlying network. The most distant, aloof doctor is subject to the same flood of emotions as the most touchy-feely one. Emotions are in the air just as oxygen is. But how we doctors choose—or choose not—to notice and process these emotions varies greatly. And it is the patient at the other end of the relationship who is affected most by this variability.\u003cbr\u003e\u003cbr\u003e This book is intended to shed light on the vast emotional vocabulary of medicine and how it affects the practice of medicine at all levels. Hopefully, the next time we find ourselves in a patient gown, we’ll better understand the workings of those who care for us. “Cognition and emotion are inseparable,” Groopman observes. “The two mix in every encounter with every patient.” In some scenarios, this mix is highly beneficial to patients. In others, it can be calamitous.\u003cbr\u003e\u003cbr\u003e Understanding the positive and negative influence of emotions in the doctor-patient interaction is a crucial element in maximizing the quality of medical care. Every patient deserves the best possible care that doctors can offer. Learning to recognize and navigate the emotional subtexts is a critical tool on both sides of the exam table.","brand":"Beacon Press","offers":[{"title":"Default Title","offer_id":46301851451621,"sku":"NP9780807033302","price":17.95,"currency_code":"USD","in_stock":false}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1842\/7735\/files\/9780807033302.jpg?v=1767743820","url":"https:\/\/k12savings.com\/products\/what-doctors-feel-isbn-9780807033302","provider":"K12savings","version":"1.0","type":"link"}