The power of facing the unfixable

Patients aren't the only ones who can feel helpless when their suffering with chronic illness persists despite treatment, according to an essay by Ronald M. Epstein, M.D., a University of Rochester professor, and Anthony L. Back, M.D., an oncologist at University of Washington, published in JAMA.

For physicians, the current medical paradigm can leave them at a loss for what to do when diagnosis and treatment aren't enough, noted an article in Medical Daily. "Too often when feeling helpless, we withdraw--by referring to another specialist, scheduling the next follow-up appointment in the distant future or blaming the patient," the authors wrote in JAMA.

By reviewing the literature surrounding positive ways physicians can respond to suffering, however, Epstein and Back honed in on two specific elements of empathy that physicians can demonstrate to help patients adapt to living with difficult conditions:

  • Turning toward. Rather than withdrawing from what they can't seem to fix, physicians can make a difference by becoming more attentive to patients' experience and asking questions about it, such as, "What is the worst part of this for you?" Simply bearing witness to patients' pain and expressing small, caring actions can provide assurance they won't be abandoned.
  • Refocusing and reclaiming. Physicians should be attuned to opportunities to connect with what is important, meaningful and generative in their lives, the authors wrote. Through this holistic approach, physicians can work with patients to 'redefine their agendas' to find ways to thrive despite adversity. The authors cautioned, however, that physicians take care not to imply patients have failed if they don't find meaning in or spiritual growth from their illness.

Though a 'tall order,' the authors acknowledged, physicians can learn to be more attentive to suffering, engage more fully and achieve a deeper sense of purpose in their work for having done so.

To learn more:
- read the article
- see the abstract