I don't know if any of you remember my Medicine Mensch column way back in April, when I described a "code" on the ICU - that is, the death of a patient despite attempted resuscitation. I just now noticed a letter to the Forward written in response later that month, which I point out now as an instance of a common phenomenon: the tendency to ascribe to me, the columnist, an attitude in agreement with the attitudes described in the column. Thus:
The letter-writer, it seems, equates the depiction of emotional insensitivity with emotional insensitivity on the part of me, the writer. This is certainly possible but I think untrue in this case. Indeed, I share his concerns about the emotional insensitivity of many doctors; on the contrary, a careful reading of the article would not find a "complete absence of any feelings whatsoever" over the patient's death. In short: depiction of the status quo does not connote satisfaction with it.
In his April 14 Fast Forward column (“Springing Into Action”), Zackary Sholem Berger captures the unquestioning introjection of emotional insensitivity into the psyches of our physicians in training. As such, he seems unaware of the recurrent abhorrence to those outside his insider’s narrative: the initial “frown” by the resident whose chat was interrupted by a nurse’s concern over a dying patient; the “workplace banter” while the life of a husband, father, brother, friend… hung in the balance; the incompetent obscene specialist whom Berger feels compelled to shield, and finally, the reassurance of “the attending… that we should not beat ourselves up about the patient’s dying, that everything had been done the right way.”
Perhaps reflecting his own indoctrination, Berger attempts to anesthetize the reader’s pain with a reminder that those outside the code are the “uninitiated,” that the complete absence of any feelings whatsoever over a man’s death is sanctioned by a review and validation of the emergency protocol, as well as by the hollow reassurance of one’s superiors and peers.