In residency, new physicians must learn to appropriately address and handle acute sickness.
In situations involving catastrophic disease (e.g., in intensive care settings), this often requires them to absorb measures of emotion associated with illness while shielding themselves from its full weight. Balanced steadiness in the face of severe illness is crucial—a core competency in its own right—because remaining calm and collected in crisis is often as important to decision making as clinical acumen. Thankfully, most residents learn to find steadiness and focus amid chaos.
This steadiness, however, must also be thoughtfully directed. It is clearly helpful for young physicians who frequently spend long hours dealing with the sickest patients with the most complex medical and social problems. But increased exposure can also ingrain steadiness to the point where it progresses insidiously into something perceived as detachment, particularly by patients on the receiving end of bad news or poor prognoses.
This issue - the cynicism and emotional insulation that can prevent illness from meaningfully moving and affecting residents as people - is something that has concerned medical educators for some time now. Finding balance can be difficult.