©️Dr. Aparna Govil Bhasker

As doctors, we love evidence-based medicine! Most of us believe in the old adage- “In God we trust. All others must bring data.” We are deeply impacted by impact factors and the graph of our pride rises in direct proportion to the number of times our research papers are cited in the literature. Today, we have journals sprouting by the dozens and thousands of research papers being published every year. We go around the world, brainstorming with colleagues and trying to make sense of these infinite numbers in an attempt to solve the mystery of human health and disease. Though we are always trying to apply the evidence to generate best practices, many times during heated discussions in conferences it all boils down to- “What would you do (WWYD) if this was your wife? WWYD if this was your mother? And saving the best for the last…… drumroll please!!….. WWYD if this was your (you guessed it right!) ….. mother-in-law?”

The biggest irony faced by medical practitioners is that while data guides clinical practice, statistics get severely skewed when viewed from the perspective of the patient and their family. The universally acceptable 0.1% adverse event rate is a one hundred percent catastrophe when the life of a loved one is on the line. Randomized controlled trials (RCT) fall terribly short when we have to break bad news to a patient’s family. Unfortunately, RCTs can’t feel the pain or the disappointment. In real life, numbers are just numbers and they have no feelings. At such times, emotions overrule evidence leading us back to the timeless question- “Doctor, what would you have done if this was your own family member?”

Medicine is probably the only profession with a direct impact on a person’s life and death. An average person would probably make life and death decisions once or twice in their entire life. Some may never have to do it at all. Doctors are professionals who have to make these difficult choices on a daily basis. We have to remain objective while everyone is panicking and remain calm in the midst of chaos. We have to keep our head on our shoulders and our heart tucked a little away. We are bound by oath to take risks on behalf of others. Well, we all know that taking a risk is a risky affair and things can go either way. We have the impolite job of being realistic and setting the expectations right. Sometimes we have to say things that people may not wish to hear. And sometimes when we say things, people may choose not to hear. At the end of the day, we have the challenging task of keeping hope alive too, for hope can be a stronger potion than any medicine in the world.

Striking a balance between objectivity and empathy is like navigating a ship through turbulent seas. If either side is lost or if there’s an excess of one, it could tip the balance and sink the ship. Published literature, studies, trials, data and numbers can at best guide clinical practice to some extent. However, rattling off numbers can never provide solace to a suffering family. The practice of medicine is beyond that and the healing potion must contain the right dose of empathy to be effective.

Some of us can overdose on empathy too. Excessive emotional involvement in every patient’s case can lead to burnout and compassion fatigue. Overwhelming empathy can be quite exhausting and we need some degree of professional detachment and objectivity to navigate the medical maze effectively. This brings me back to the WWYD question. Throughout my career, I’ve been taught to treat patients as I would my own family. While we hold our loved ones dear, treating every patient as kin would lead to an emotional roller coaster. Trust me, it’s not good for any of the stake holders.

The journey of a doctor is a delicate balance between objectivity and empathy. We begin our careers armed with a solid foundation in evidence-based medicine and data-driven practices. With experience, we come to appreciate the necessity of complimenting these with empathy and a profound understanding of the humane aspect of healthcare.

When science marries compassion, the journey of healing begins. Those who find this equilibrium our blessed and experience immense gratification and fulfilment in their professional lives. For others, it remains a work in progress. It’s challenging, yet attainable. It’s not easy, yet possible. It is a continuous journey of growth and learning, shaping us into better healers every day.