Surgeons, anesthesiologists, emergency doctors or anyone who routinely sees patients (or operates on patients) who could soon spiral down to death probably feel stress in many situations because they don't want their patient to die
but do you think a doctor/surgeon who did not care about people or did not have a conscience would not feel stressed when things spiral? and do you think that this would actually make them better at what they do?
I'm going to limit myself to 15 minutes of typing. I am on call tomorrow and really should have gone to sleep an hour ago. This is obviously a complex topic and should be a book in and of itself, but let me try to do it justice.
For context, I am in the final stages of my 7 year vascular surgery residency. It is fairly rare that a month goes by that I don't personally care for someone who is about to die. Last Thursday, I admitted a patient with an infected endograft who after 3 family meetings, we made DNR/DNI and terminally extubated this morning. It was the first time that I was the primary talker in all of the family meetings. While I had faculty present in two of the meetings, it felt as close to my name being on the chart as I have experienced thus far. With that fresh experience in mind, here are my global thoughts:
#1 Physicians are humans. They exists on the spectrum of the rest of society. There is little that makes them 'different' or 'special'. Virtually every sub-set of physicians follows this same rule. Thus, surgeons, while they may have some stereotypical traits are more similar to the rest of society than most people think.
#2 People are selfish and egocentric. It doesn't matter what sub-population you dig up and while every population exists on a continuum, people are going to look out for their own interests over that of others. This is no different with physicians and patients. I would like to think that there is some 'ethics' or 'code' that would make physicians less likely to be this way, but nothing in my 10 years of exposure to medicine would lead me to believe this. I certainly have faculty that are angels, but if I look at the entire population of people that I know as "physicians" or "surgeons", their actions are modulated by what benefits them or impacts them to a significant degree. While it is easy to bash people for this, in my opinion, it is the norm.
#3 It is pretty rare to come across someone who globally "doesn't care about people". However, as in #2, the number that care about other people as much or more than themselves is rare.
With those three said and to answer the original question, there is a balance that is necessary to being a good physician. You can not get caught up emotions of death and dying while you are treating someone, obviously you will be less capable. But, by the same token, the number of times that I've seen delayed, inadequate or simply bad care stemming from physician needs trumping patient's is a dime a dozen. Most of the time I find that physicians (or others in healthcare for that matter) lie to themselves as well as the rest of the world. Sometimes it is by hesitating or deferring care. Sometimes it is offering less time/attention than is likely necessary.
Went over a little bit time wise. So I'll just end with the disclaimer. I'm pretty sure you could replace 'physician' with any other occupation and the same would hold true...
#Jaded