Why Even Good and Empathetic Doctors Should Avoid Over-Identifying with Patients

I have seen a topsy-turvy world. There are births that take place in a magnificent and warm living room in Bnei Brak. Not a typical home birth, but the birth of a book.

Hani Weinrot, with the help of Israel Meir, the talented son (like her other children) of my dear friend Rebbetzin Tziva Meir, collects chapters on faith and trust. A human doctor may roar – who will not fear? Hani. She became a celebrity following her battle with cancer. With great strength and a lot of humor, she teaches us, the doctors, that we are not healers of all flesh; only Hashem performs miracles. Every day I flip through a chapter from the book, inhaling deep breaths of pure, complete faith.

A Cross on the Surgery

Hani foresaw blackness. The doctors looked at her with a pessimistic gaze. But there are also doctors of another kind. It was a wintry, gloomy day. I enter the clinic of a God-fearing orthopedic doctor at Sha'arei Tzedek with my mother, a dear and modest man, to decide whether to revive her knees with surgery. She struggles to walk and suffers from pain. Her hesitant steps in gray boots and her moans of pain tipped the scales: surgery in a few months.

A summer morning, and the sun shines on us. I again accompany my mother, this time in a summer dress with a red hat and sandals, for a pre-surgery check-up. Now my mother walks hesitant steps in red sandals, a red smile on her lips. Here, the orthopedist's wonderful humility was revealed. He looked, pondered a moment, and marked a cross on the pre-surgery form. Then he turned to my mother with kind, smiling eyes: "Ma'am, you look great. You are currently functioning well. There are also risks with surgery. Let's postpone the surgery for several years." Indeed, years passed, and after gray hair established its presence on her head, my mother had her knee surgery – in its due time.

My mother, of blessed memory, passed away a few years ago. Maybe if she had aged more, she would have benefited from a new study on cartilage repair. The study examined over a hundred men and women suffering from knee cartilage wear, exactly what she had. Researchers used a new patent to repair the cartilage using self-tissue. The patient's own cells were placed in a pig-derived absorbable collagen membrane, which the surgeon implanted in the damaged area. The surgery results are similar to the classic surgery, and the natural material prevents side effects and complications, ensuring long-term durability. On second thought, it's very likely my mother would have declined the pleasure of a joint from that animal, "the other thing," even at the cost of daily suffering…

Draining Empathy

My father might have also benefited from the new medical technology if he had lived longer. My father, of blessed memory, passed away from a sudden heart attack on the eve of Shabbat Chanukah before completing the sixth decade of his life. His heart stopped suddenly. Maybe his bitter disappointment with Menachem Begin, whom he admired, for supporting the Camp David Accords, affected his heart. The pacemaker implanted in his heart a few years earlier stopped working.

Last year, researchers developed functional pacemaker cells made from human stem cells for the first time. These cells were implanted in the hearts of rats and functioned like a biological pacemaker. It is estimated that such a pacemaker will last throughout the patient's life. Now, a clinical trial will begin attempting to create human pacemaker cells for human implantation. My father didn't live to see this. But he took great pride in his eldest daughter's medical studies and was genuinely happy with human wisdom that enhances the Creator's world.

But Dad did not experience the caregiver's experience. Being a caregiver is shouldering the patient's sorrow and pain. It's providing an anchor in the stormy sea, boarding the ship, and feeling the crashing waves – and it's exhausting. Thirty years of care carve their mark on a furrowed brow and a slumped shoulder, sleepless nights, and heartaches. Indeed, many doctors leave the field and do not continue in their profession for long. However, there are differences between groups of doctors on this matter: research in Scotland found that doctors who over-identify with patients' pain experience increased burnout in their work. The researchers' suggestion is to learn the skills of creating empathy, allowing for wholehearted support without personal identification with the patient.

(Photo: shutterstock)

Aligning Aims

Against a warm heart stands the warmth of our land. Sometimes I ask myself why Hashem imbued the atmosphere of the Land of Israel with hot, oppressive summer? I see before my eyes, as sunny as it is, pregnant feet swollen inside pressure sleeves, boys in khaki on duty in the burning sands of Gaza yearning for refreshing coolness, and a ruddy farmer plowing golden fields as the sweat drips. Couldn't Hashem tailor us a land more suitable for our needs? There's no doubt that everything is intentional. But He created for us a beloved and warm land, along with a spice. Researchers managed to produce a unique fabric from plastic polymer with the ability to cool the sultry body, potentially reducing the need for air conditioners and the frequent power outages due to their intensive summer use.

In conclusion, the intention is the main thing, and indeed everything is directed from above, but sometimes we are also required to align intentions. Rabbi Sabato introduced me in his book to the concept of aligning aims. For those who haven't enjoyed the book, it involves inserting a device into the cannon barrel and checking against a distant target to ensure the gunner's sight is aligned with the cannon’s angle. But in the reality of battle, there's no time for that. So there's combat aim alignment: finding a suitable target, aiming at it, firing a real shell, tracking the shell's path, and adjusting the gunner's aim accordingly. And I know a different kind of combat aim alignment, much like in tanks: a woman can repeatedly be faced with the question of whether another pregnancy aligns with her aims. Perhaps it's more correct just to reach out and accept the abundance, and then the forces amazingly suited to the mission of motherhood tangibly reveal themselves.