Jefferson Journal of Psychiatry


There was one experience during my medical school psychiatry rotation that I could not forget. In a classroom on the cardiology ward, I listened, transfixed like a child at a magic show, as a psychiatrist interviewed a man who was recovering from a heart attack. Initially the man denied any stresses in his life that might have affected his health, but as he went on, a different story unfolded. He spoke of his recent retirement, his wife's dissatisfactions and hostility, his disappointment with his children, his growing sense of failure and futility, and the recurring tightness in his chest that he had tried to ignore. His doctors colluded in his denial, for they were too busy with his EKGs and cardiac enzymes to wonder about his emotional well-being. I could see the despair, but also the hope in his face as he talked with the psychiatrist. At the end of the interview the patient was in tears, and though I hid them from my colleagues, so was I. Powerful and mysterious stuff, this business of feelings, much more complicated than anything I had yet encountered in my medical training, but also much more threatening. It seemed that talking to patients about their feelings would bring into question my own feelings, a Pandora's box I wasn't ready to open. A seed had been planted, but it was not to be tended to for some time to come.

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