Great cases, interesting cases and sad cases

When I was in residency my attendings would tell us that, “every case is an interesting case”!

However, I think that Dr. Hee was disturbed about much more than that fact that his peers “misclassifed” this case as “great” when in fact it is “sad”. I seriously do not believe that his attendings implied that the case was “great” for the patient but simply “great” as an informative teaching case. Dr. Hee should know the difference unless he suspects that he is a resident in the most sadistic internal medicine residency program in the country!

I doubt it.

Physicians are not immune to grief or sadness over witnessing the suffering of their patients. I have teared up and felt great pain on more than one occasion and I know plenty of doctors who have openly wept at the passing of a patient but this is the first time that I have ever heard of a physician becomeing grief stricken at a case conference and then critizising his fellow physicians for not doing the same!

I have to agree with Rangel on this one. Physicians in training learn early on (starting in gross anatomy lab)to intellectualize and detatch. It’s a healthy defense mechanism. In the clinical arena we’d never make it through the day if we weren’t at least partially immune to the whole range of “appropriate” emotions. It has nothing to do with how much compassion we have. A second year resident should understand that.

Re: mastocytosis. I have never seen a case so it would be interesting for me.

Geena. I think that Dr. Van Hee’s intent was exactly to critique his peers for their lack of emotionalism and for even being excited about the case! In his post he did NOT make any attempt to explain the context of a case conference nor to note that the apparent emotional detachment of the residents during such a conference is not at all predictive of how caring a resident physician is in actual patient care! Without these explanations his post appears very bias and poorly written. I can’t believe that Dr. Van Hee is completely unaware of these issues or the falicy of his thinking. I believe he attempted to draw a direct comparison between his “politically correct” emotional and “caring” response and the seemingly cold, uncaring, and (ironically) clinical responses of his fellow residents.

Very true, Dr. Donnell.