The Loneliness of Being a Physician

Gregory A. Hood, MD

Disclosures

February 12, 2019

In This Article

Overcoming Rejections, Regaining Connections

The life of a modern American physician is replete with rejections. There are the rejections of orders via incessant prior authorization criteria, some of which are insurmountable; of nonadherence and no-shows; and of the "Dr Google" experts who, perhaps unintentionally, repudiate the entirety of the physician's training, education, and experience on the basis of a self-fulfilling, nonacademic Internet search, as well as the omnipresent sense that harder, faster, quicker is never going to be enough.

For general internists, there can be the rejection of their entire life's calling, as generations of medical students have rejected this career path, thanks to the draconian and vampiric effects of the American Board of Internal Medicine's certification policies, and the repudiation of the value of the training and experience of the "doctor's doctor" by the government and private payers.

To practice in the backdrop of these rejections in a healthcare system that has isolated us very effectively should be of fundamental concern to the nation, as it continues to face a physician shortfall, particularly in primary care.

The remedy for such stressors and challenges is, rather simply, to congregate, to bond, to not be alone, to not be lonely.

One would wonder whether there is not a design flaw for stress to affect our bodies and longevity thus. The answer, though, is more sublime. The remedy for such stressors and challenges is, rather simply, to congregate, to bond, to not be alone, to not be lonely.

The chronic provocations of the broken-down healthcare "delivery system" relegates physicians into a chronic and unsustainable fight-or-flight mode. This, along with sleep deprivation (by quantity and quality) and myriad deleterious effects (including those on systemic vascular resistance and tissue inflammation, among others) exact a significant toll on those who have committed their lives to being of service to others.

The tragic nature of these circumstances is not that physicians who have assumed these service roles do not live trouble-free lives. Rather, it is that people of goodwill, great intellect, and compassion are not perceived by society and those around them and, further, that these consequences curtail the longevity and effectiveness of those healthcare providers, who are a critically limited resource to our society today.

One of the chief limitations of our society, and our language, is that we recognize each other but we do not "see" each other. In parting, we may say to others that we will "see them," but we don't "see."

This realization was well represented in the interactions of the Na'vi in the movie Avatar. Neytiri says, "I see you"—the traditional Na'vi greeting meaning "I see who you truly are." There was an interesting effect in the wake of that movie of a "blue funk," of heightened pain caused by the sense of human loneliness standing in stark, 3D contrast to the idealized relationships portrayed on the silver screen.[5]

We can't hope to replicate that world in this one, but we can surely do better than we are doing currently in this one.

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