Trust is the Essence of the Doctor-Patient Relationship

By Sharon Ben-Or, M.D. | Published 12/5/2018 3

good-doctor

Photo source: iStock

“Because I don’t trust any of the surgeons.” 

There I said it.

It was both cathartic and horrifying to utter those words in response to my husband’s question of why I don’t call the answering service.

It has taken me 3.5 months, 1 surgery for cancer at the time we were about to start a family, and 2 surgeries for complications from the original one for me to get to the point to utter those words.

The doctor-patient relationship is failing

It had been simmering for at least one month. Both my surgeon and I ignored the symptoms. I became more irritable. I had less patience with him. I was more discouraged.

He responded by trying to see the silver lining and letting me know that we were close to the finish line.  Instead of cheering me up, his words had the opposite effect, further enraging me, further frustrating me.

Hindsight being 20/20, I was depressed. I was crying several times a day. This finish line that my surgeon referred to was nowhere near in sight and I felt deceived and lied to.

I was emotionally drained and I didn’t have the strength to keep going. So I chose anger and animosity to hide my fear, to hide my despair, to hide the depressive thoughts that became harder to ignore.

I was in flight or fight mode and I didn’t have the strength to fight anymore.

I didn’t need my surgeon to cheer me up

I didn’t need my surgeon to cheer me up.  I needed him to acknowledge my feelings. I needed to be heard by my doctor.

The thing is that I didn’t know how to express to him that that was what I needed, so he tried to help me out the only way he knew how which was to see the glass as being half full. But I could only see it as half empty.

All that I wanted him to do was to tell me, “I know that this whole situation sucks, and I’m sorry that you have to go through this.” When he finally said those words, it was too late.  I had lost trust in him and all surgeons.

But I am a surgeon

The ironic thing about this is that I am a surgeon, and my surgeon is a friend and colleague.  How can I say that I don’t trust surgeons when I am one?  Does that make me a hypocrite?

How do I act toward my patients who have complications?  As a surgeon, I knew that these complications were out of his hands, that he was doing everything by the book, but as a patient, I blamed him.

What I discovered

The next day, I spoke on a panel of cancer survivors at the medical school.  All of the speakers, except for me, were 10-15 years out from their diagnoses while I was 10-15 weeks out.

As I listened to each one of them share their stories, I noticed a pattern that there was one person in the treatment team that they resented because that person just didn’t get it.  Fifteen years after the incident and I could still hear the anger in their voices. I didn’t want to harbor these feelings for the rest of my life.

How to move on

How do you forgive someone who doesn’t know that you feel that they wronged you?  A better question is, “How do I get closure?” How do I let go of this anger or resentment so that I can move on?

I had to do the thing that terrified me the most: I had to shed my armor of anger and show my vulnerability to my surgeon.  I had to reveal to him the frightened person inside.

Related Article:  Getting Your Doctor to Really See You

One week later, I was readmitted to the hospital for a possible wound infection.  My surgeon was out of town and came to see me when he got back.

As I sat in the chair, I said to him, “I need to tell you about my existential crisis.”  My heart was pounding and I was shaking inside.  I told him about not wanting to call the answering service, speaking at the medical school and the persistent resentment, and the need for closure.

Now came the scary part

Now came the scary part. I stared at my patient bracelet and played with it as I took a deep breath. I hugged my knees to my chest. I was trying to make myself as small as possible.

“I guess the person I resent most is you, and the only way I can think of to move on is to explain to you how I feel. Every time you have to reoperate on me, every time there is a complication, I feel like my life is put on pause.  And I see everything else moving forward in the distance: my practice, life in general, my end goal, chemotherapy, everyone else. 

When you tell me that I can resume regular activities, I run as quickly as I can to catch up to those things, but I never catch up because I have to stop again.  My fear is that when I can finally start back with life, I will never be able to find those things and I will never be able to catch up with my end goal, which is having a baby. 

So when I get angry with you, I am scared that I will never be able to get pregnant; I mourn that dream. I am like a porcupine: I roll myself in a little ball to protect myself and let my quills hurt whoever tries to come near me.”

Related Content: Questions to Ask Your Doctor When You Are Admitted to the Hospital

An unexpected explanation

I finally looked up from my bracelet while my body is contorted in some surreal pose not unlike a porcupine. I was scared of my surgeon’s reaction knowing that this is going to be a turning point for our relationship.

He said exactly what I needed to hear: “Thank you.”  He then explained to me how difficult it is to take care of a friend who has had complications and knowing that that is what is keeping me from having a child.

He coped with those feelings by distancing himself from me and ignoring my resentment and anger. I didn’t understand the emotional toll that he went through and how hard it had been for him. I realized that he had created an armor of optimism to protect himself.

Closure

We both smiled at each other.  At that moment, I knew I had my closure and that he had his. All it took was being vulnerable to my surgeon and him being vulnerable to me.

My surgeon finally got it.

He regained my trust.

Sharon Ben-Or, M.D.

Sharon Ben-Or, MD is a thoracic surgeon in Greenville, South Carolina and the Associate Residency Program Director of the General Surgery Program at Greenville Memorial Hospital. She is passionate about resident and medical student education. Her outside interests include knitting, cooking, and yoga.

Comments:

  • Nothing like starting off my day reading and learning about something cool. Your blog post accentuated my breakfast perfectly! Thank you :)

  • Hello
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    Keep up the good work

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