How much should physicians share with patients?

One aspect of the practice of medicine that I struggle with is how much of my own experiences to share with patients.

Recently, I had a first-time mother bring her newborn in for a weight and color check. Breastfeeding was very difficult and the poor mom was in tears.  As she sat across from me with tears dripping from her chin, trying to get her baby to latch, I contemplated how much of my own challenges as a new mom trying to learn how to breastfeed I should share with her.

Physicians walk a funny line between being human enough to show compassion, caring, and a good “bedside manner” but distant enough to be objective and somewhat removed from the sorrows of our patients. While we sometimes cry with our patients, we shed more tears behind closed doors. Our own pain should not obscure the suffering of those for whom we care. Knowing when to let the tears fall out of empathy for another’s hurt and when to keep those emotions in check in order to be a steady anchor for those adrift on the sea of pain and grief is difficult.

As physicians, we are also wives and husbands, mothers and fathers, daughters and sons, walking a similar path in life. We wrestle with our kid’s colic and broken toes, our spouse’s cancer, and our mother’s dementia. While we can offer the “medical” answer about the causes or the symptoms, the treatment or the prognosis, sometimes we can offer more. As fellow travelers along these same roads our patients take, we may be able to commiserate or share our learnings, not as a medical professional, but as a family member or a patient.

That said, this advice must be judiciously and carefully given. While I may relate to a patient’s mom because our kids are the same age, I am not just another mom chatting in the school pick-up line. As the doctor, I have a certain authority which colors any friendly recommendations I offer. This usually makes me somewhat circumspect in what I choose to share. Sometimes I probably say too little for fear of saying too much. In addition to wanting to provide the best and most appropriate information, I also hesitate out of concern for appearing too familiar, recognizing that each patient’s journey is unique even if the diagnosis is not.

So, as I sat in front of this young mother, recognizing the fatigue and feelings of being overwhelmed that used to stare at me from my own mirror, I considered carefully what to say and how to phrase it. Leaning forward, I told her that I was already a doctor when I had my first baby and still felt uncertain and struggled with figuring out the whole breastfeeding thing. I hope that what I shared about my own experiences reassured her and helped her feel less alone.