Point / Counterpoint I

Do doctors in training get callous over time?

Certainly, over the last two years, some things become easier. It is easier for me to put a needle into someone, and indeed, put a knife to skin. I spend less time talking to patients about where they're from, their family, their job, their life. I adhere to time limits I set for myself for difficult family meetings. When I do chest compressions, I push hard and fast.

These are all adaptations necessary to being a resident. As I progress, the demands on my time increase greatly. My responsibilities increase likewise. If making a small cut to place a central line or putting in a large needle to thread an epidural catheter or CPR are necessary, I no longer hesitate.

I remember being a student when I could be in a patient's room for an hour gathering a history. Perhaps a little aimless, my questions would wander the span of their life, and in doing so, uncover a lot that is important, but not medically essential, about the patient. I would arrive at the scene of an emergency and be arrested in panic. My movements would be too reluctant, my hesitancy too pronounced.

Yes, doctors become roughened in this field. We change so as to filter out that information which is not necessary, and then slowly, to dispense with asking about it. We learn to do things that may cause a patient pain or discomfort or harm because we sincerely believe that the patient's health requires it. Is this callous? The counterpoint to this post will come tomorrow.