Crying?

[Lyrical M]

I debated this with a friend, and thought I'd put it out there for your professional opinions.  Do you feel it is okay to cry a little with a family or person when you tell them that their loved one passed away?  I don't mean like bawl your eyes out and collapse into a messy pile of tears.  But, just a little sniffly or watery-eyed, for example?  He feels that it's unprofessional, and you must remain a proper composure at all times.  I feel, if it's sincere, that it can be empathetic, supportive, and therapeutic to them, and can help them through the initial stage.  I recall one doctor I saw when shadowing at a hospital, he flatly told the family as if he was reciting a memorized line, looked annoyed when they leaned on him to cry, and walked away after 5 seconds.  I certainly don't want to become that guy.

 

Thanks

[DiggySRNA]

My exact words to the Internist I shadowed, " have you ever cried with a patient?".

Her response: I CERTAINLY HAVE. 

 

And what'd you know...her next patient (50ish) who was waiting, had lost his son - killed on the highway over the weekend. When he explained the horror story, she hugged him and her eyes got watery. Just from witnessing that my eyes got watery too.

 

 

She was this guy's PCP for about 15 years.

[Acebecker]

I was going to tell my crying story, but it's still too fresh. 

 

Whether or not it's ok to cry, it happens. You have to be careful with it, but there's nothing wrong with being human.

[GatorChomp]

While professionalism is important in most cases, we're all human. To deny yourself of crying in an intense, emotional case is to deny yourself of compassion and empathy. We're all in healthcare to help others and when things take a turn for the worse, sometimes crying is the most logical response. The patients who may see you cry in an intense situation may grow to respect and appreciate you as a medical provider even more.

[whoRyou]

I found this interesting A Nurse's Guide to Professional Boundaries No throwing tomatoes please LOL IMHO, It's more than acceptable. 

[G. Davenport]

Be real. Be nice. Have compassion. Crying is not a question. If it happens it happens. The doc the op refers to is a heartless person who will regret his behavior when sympathy becomes empathy and it's real.

[EMEDPA]

I have. I had an "ER regular" who used us as his pcp for years. old guy. stubborn.

when he had a cva he requested I come see him in the hospital and "check over all the doctor's orders to make sure they were ok". he refused any order until I ok'd it.  I visited him several times in the hospital. a few weeks into his stay he aspirated and died. his wife told me " you were the best doctor he ever had, thank you so much".

you bet I cried. not the first time. won't be the last.

[jmj11]

I agree.  It has hit me when I least expected it. I remember (once when I was doing student health at a college) that a girl came in. She was distraught.  She had a restaurant uniform on.  She told me that she was afraid she was going to commit suicide so she came to student health. She worked at Ponderosa Steakhouse. She left her dorm, went to work and they told her that they had schedule her wrong and to go home. She got back to the dorm and unlocked the door only to catch her fiancee having sex with her roommate and best friend. She had dated this guy since highschool and they were getting married that summer.  She had introduced them to each other and often hung out together. Both of them were yelling at her as she raced from the room that it didn't mean anything but they were just "having fun." She was so devastated and started to bawl and I was shocked when I did too. 

[Guest Paula]

I get misty eyed now and then and can't really predict what starts it.  Sometimes I will say "Now, I'm going to cry, you make me feel sad too".  I pull a kleenex out of the box for the patient and one for myself.  Somehow that box of kleenex and the offer of one to the patient can bond you to them at that moment.  

 

We are all human and tears tend to cleanse the soul.  Weeping can last for the night and joy comes in the morning. 

[LT_Oneal_PAC]

There is a particular patient presentation, that I chose not to reveal, that will make me cry since I have lived through it. I see their eyes and I remember looking at my own reflection during that time. Can't help but want to hug them, tell them it will all be okay. Cry a little just thinking about it. I see absolutely nothing wrong with a few tears with a patient. I wish someone had shared a few with me, to know I wasn't alone.

 

Also child abuse gets me. Not that I've experienced that not has anyone that I know personally. Just find it to be the ugliest of mankind. It doesn't hit me immediately. Usually I get back to my desk before I lose it. I wouldn't want anyone to see that. So I suppose it depends on the situation.

[EMEDPA]

child abuse just makes me mad. I was very close to hitting a father once who had snapped his 2 year olds humerus while "spanking her".

[rev ronin]

child abuse just makes me mad. I was very close to hitting a father once who had snapped his 2 year olds humerus while "spanking her".

You're human in that you wanted to... professional in that you restrained yourself.

[ventana]

yup (tearing up, not full on bawling)

 

probably atleast monthly in my line of work (geriatric house calls)

 

We are human, it is a real thing

 

 

When I stop doing it is the day I should retire.......

[EMEDPA]

You're human in that you wanted to... professional in that you restrained yourself.

so after posting this what do I end up seeing tonight...yup, child with "concern for non-accidental trauma"

[TWR]

We are in a profession by choice that  can evoke many emotions and they are all good.  Where in the definition of "professional: does it say you can't cry?   Each situation will bring what ever emotion is appropriate and to have empathy with a patient is what we are about IMHO.  S..T!  I cry at movies.  After all we are human too.  The stoic SP who seemed annoyed was probably having a difficult time "controlling" their emotions and his/her defense was to be "distant".  Anyone who thinks men don't cry are wrong.

[jmj11]

I also cry when I spend 80 minutes with a patient who has driven 500 miles to come, who has been everywhere, tried everything, has a 400 page outside record file, a box full of medications, with six major comorbid conditions add complexity and he says I'm his last hope and then he will kill himself. But then, his insurance pays us 0 for the time, the occipital and supra-orbital nerve blocks for some insane reason.

[JFarnsworth]

Crying is a natural response. I have done it and don't intend to "train" myself to stop. I have heard from a couple of docs, "people die, get over it" or, "bad things happen, you can't get emotional when they do". And my answer is the day I stop feeling for my patients and their families is the day I should stop being a PA. I think it's more unprofessional to not show any emotion-- as though the patients were just numbers or diagnoses to you and that you couldn't care less. 

[medic25]

There is a particular patient presentation, that I chose not to reveal, that will make me cry since I have lived through it. I see their eyes and I remember looking at my own reflection during that time.

 

This can be very tough; as the parent of a congenital heart kid I always feel a strong kinship with other CHD families.  I recently took care of a 5 year old girl with congenital heart disease who was 2 weeks post-op from her last surgery; in speaking with her parents, she had been at the same hospital and had been operated on by the same surgeon as my daughter.  Speaking with them brought back a flood of memories that made it very difficult not to tear up.  I haven't spoken with the surgeon since the operation, and when I paged him I found that i was hoping he would call back personally just so I could thank him for all that he did.

[gbrothers98]

I debated this with a friend, and thought I'd put it out there for your professional opinions.  Do you feel it is okay to cry a little with a family or person when you tell them that their loved one passed away?  I don't mean like bawl your eyes out and collapse into a messy pile of tears.  But, just a little sniffly or watery-eyed, for example?  He feels that it's unprofessional, and you must remain a proper composure at all times.  I feel, if it's sincere, that it can be empathetic, supportive, and therapeutic to them, and can help them through the initial stage.  I recall one doctor I saw when shadowing at a hospital, he flatly told the family as if he was reciting a memorized line, looked annoyed when they leaned on him to cry, and walked away after 5 seconds.  I certainly don't want to become that guy.

 

Thanks

I work in a bit of a special situation in that I have been at the same place since 2001 so I know a lot of the  ED regulars for better or worse. I also practice in the town that I grew up in and my ED is the same one I came to for late night bronchospasms and football concussions. That means every shift I run the risk of seeing patients whom I know from growing up, some peripherally, some very well. I have had to pronounce the father of a high school classmate dead, I saw my first girlfriends grandparent with a severe SAH on coumadin that fortunately was DNR and saw her through in the ED till the end with her family, I have had to tell a friend of my family she had lung cancer and then see her every time she had a problem for the next 2 years till she died. 

I have also saved a high school classmates mother in anaphylaxis (actually the epi did) and defibbed a relative of a coworker out of vfib arrest.

So I have sniffled in sadness and joy for other people. Some had to do with being tired, other times emotional. I think it is all fine as long as you can keep moving forward and do the right thing.

As for your example above, I too had a similar example when I first started working. I came away from that thinking what a pr!ck. The doc you reference above is a pr!ck too.

I choose dont be a pr!ck.

G Brothers PA-C

[Guest Paula]

child abuse just makes me mad. I was very close to hitting a father once who had snapped his 2 year olds humerus while "spanking her".

 

This brought back a memory of child abuse case I saw about 8 years ago.  2 y/o with cigarette burns on his hands brought in by his pregnant mother who had 2 black eyes.  The boyfriend did it.  I reported it and he was found by the police, jailed, and restraining order put in place.  He eventually went to the "Big House".  

 

I cry when I see how kids are  neglected and abused.  Makes me hug mine more and they are all adults now. 

[Guest JMPA]

To dismiss the doc that the op was referring to as "heartless" or as a "pr*ck" is wrong. This  may be his coping mechanism. Some people deal with death and morbidity in different ways.

[jsfelder0417]

I have gotten misty eyed with pts a few times. Miscarriage gets me, as I have felt that pain. Also, I have teared up a few times with my war vet pts. They know that I have done tours in the sandbox, and they open up to me about PTSD, and the other combat related emotions. One of my most rewarding pt interactions was with a Vietnam vet. He found out I had been a medic prior to becoming a PA. So he greeted me with, "Man, it is sure good to have 'doc' taking care of me again." I shook his hand and said, "Welcome home, brother." He got teary eyed and said that in the 45 years that he has been back from 'Nam, that was the first time someone welcomed him home. I'd be lying if I told you I didn't tear up too.

[arosswoods]

@jsfelder0417 now we are all gonna cry

[ToppDog]

To dismiss the doc that the op was referring to as "heartless" or as a "pr*ck" is wrong. This  may be his coping mechanism. Some people deal with death and morbidity in different ways.

 

Not only that, but you have to remember that this was the mainstay of medical school training going waaaay back.  It has been ingrained in many MDs that they need to keep emotions out of their practice, that it clouds their judgement & makes it harder to keep their work lives & home lives separate, & is one of their defining differences between doctors & nurses.  Granted, this is now changing due to an increased push for patient empathy as well as an increase in females in medical schools, but you're still going to see many MDs seem a little cold & non-emotional because of this.  I've worked with several who came across an cold fish in these types of situations, only to dissapear to their offices for a bit & come out later with red puffy eyes saying their allergies must be acting up.

 

I think it can be beneficial to the provider as well as the patents & their families if it happens.  It shows you care, & it's better than keeping things bottled up.  As others have said, if it happens, it happens.  I have several movies I always incorporate into my students' curriculum to drive this point home, as well as this video made by the Cleveland Clinic.

[user1234556]

I remember, as a student, having a discussion along these lines with a pediatric intensivist who was precepting me at the time. They were more or less speaking generally rather than directly to me, but the gist of the talk was "being highly emotional makes you worthless to the ICU"; every patient requires your ability to quickly and efficiently shift gears, and every family is deeply concerned about what's happening only in one room. The second part of that conversation was related to deaths on the floor, and that particular intensivist's exact words were that they always cry when a child dies, "and the families seem to appreciate it".