I think it is a hard one. My guess would be that not all doctors are in it for the people. Some people purposely turn to fields like pathology precisely because they don't really need to have much to do with patients. I guess surgeons don't really have to talk to them much. Anesthetolegists (however you spell that) get to have the pleasure of seeing people go go sleep... (And hopefully wake up again). Some psychiatrists see themselves primarily as medication prescribers.

Even if doctors do start out as people people I guess one fast way to turn from a people person to a non-people person is to spend a number of years working for the public health system. Too many people too much need not enough funding. Some of the clinician's I've dealt with in the public system have said some really very terrible things indeed to me... I couldn't work it out... Eventually it dawned on me... They have wait lists up to their necks and there is so much pressure to get people in and walking out with a prescription in their hands as close to schedule as possible. If you are running late then it means that patients are waiting and you don't have to wait for patients. My doctors clinic back home used to be 15 minutes behind schedule on purpose so that the doctor never had to wait for a patient.

I think it wears people down in the end. Not all of them. But some of them.

I think the not caring thing (the not feeling guilty thing) is a defence. Sometimes we need to distance ourselves and say 'there is nothing we can do' because if we didn't do that then the burden of it all, the pressure of it all would be overwhelming to us.

If he did take it on board that he didn't help someone enough and that is why they killed themself... Then he might feel so bad that he couldn't go to work the next day. Then how many patients miss out? I don't know... Just trying to understand things from the other point of view.

On a related note... My t discharged a patient and he killed himself. I found the coroners inquiry online. He was absolved from blame but there were quotes from the court hearing. He sounded really messed up about it... Said that he was traumatised from it... Said that in similar circumstances next time he would admit the person instead of discharging them. The person asked him 'even though you believe that clinicially it would be the wrong thing to do' and he said 'yeah. even when i believe that clinically it would be the wrong thing to do. i did the right thing clinically in discharging him but he killed himself. i don't want other patients to do that even if it means that clinically i do the wrong thing'.

Messed up. Don't know if anyone pushed him on the 'there are 30 beds and 30 patients in those beds and then you get this patient and so who are you going to discharge' line...

I don't know what to say.

Sometimes the world seems too cold.

I'm sorry.