By Diana Londoño, MD 

My 5-year-old proudly told me during lunch, “Did you know animals don’t cry?” When she told me this, I had to think about it and then immediately Google this. Having small kids teaches you many random facts, including that sharks don’t blink because they don’t have eyelids.

So, when she told me her new fact, I was intrigued.

Animals, unlike humans, do not have a prefrontal cortex.

This is an area of the brain involved in planning, decision-making, and processing emotions. Living beings can have primitive needs such as fear, hunger, and need for sleep, but a key difference is that we have feelings such as disappointment, excitement, tranquility, optimism, or motivation, to name a few.

We also can feel extreme sadness or happiness that leads us to tears. While animals produce tears, this is only to lubricate their eyes, not to cry. Animals do not have this complex processing of emotions, and neither do robots.

As much as we can build algorithms for computers, they cannot detect the nuances of what makes us human, which is the ability to have and process feelings.

What have we learned in medical training?

In medicine, we have been trained to be goal-focused, assertive, determined to achieve goals, and have left little space to balance out processing all the emotions that come with being a human and a physician.

As physicians each day seeing patients, we may feel frustrated, grateful, disheartened, defeated, connected, excited, uncomfortable, all within a span of 15 minutes.

However, we are trained like soldiers to stay focused on the task at hand, which is seeing a multitude of patients, finish completing a day-long ritual of a million computer clicks, making sure all requirements are done to reach a certain billing criterion. But are we allowing space to be present and process the patient’s fear, doubt or anger as well as ours?

If we do not feel comfortable processing and acknowledging our own emotions, how can we then be present for others? Most patients feel “listened” to when we ask about symptoms but are we truly listening and enquiring about the feelings they are experiencing? Everyone wants to be truly “listened” to and acknowledged, and that goes beyond the superficial: “How are you today?”

Stopping to discuss our feelings with a colleague is usually a process that is not welcomed, as we only have a limited time to discuss what we are doing that day, or maybe to discuss a patient’s symptom, diagnosis, or treatment. We repress what we are feeling about our day or a patient’s encounter. Yet, if we do not label and process our emotions, they will not go away, but instead, they will show their toll one way or another in due time.

Even in the morbidity and mortality conferences held in surgical departments, we will spend an entire hour, splitting the minutiae of how an error can be prevented but leave no time to discuss how the presenter is feeling not only during but after such presentation.

I know presenting has caused me to feel fear, shame, anxiety, inadequacy, and quickly it will transform into imposter syndrome if left unprocessed. But who is helping us during these normal human experiences? This is never discussed as we are expected to carry on the day as if the tumultuous number of feelings has not coursed through our mind and body.

Why is acknowledging feelings, discussing them, and processing so important?

Because it is the essence of what makes us human and differentiates us from animals or robots. Expressing emotions can connect us because we understand we are not alone in feeling frustrated, nervous, shame or guilt.

We all feel it. We are just not “allowed” to express it. Many times, we have been told in medicine not to be too emotionally involved or overwhelmed by the emotions we are experiencing — as if this makes us a better physician.

How can we proceed?

In medicine and health care, this is a time to train, act, and lead with a goal of focus and determination and compassion.

With compassion, we build awareness and understanding that we are human, imperfect, and full of feelings and emotions, which gives life its richness, depth, dimension, and complexity.

So, the question is: how do we want to continue?

Do we want to continue to be a nation of physician robots devoid of feelings, impersonal, distanced, and aloof to the human in front of us? Or do we want to embrace our own humanity and dive into the essence of who we truly are? It may be uncomfortable, but anything worthwhile is.

So, let’s be uncomfortable and change the narrative to truly get to a place where we can fully express our humanity.

Let us incorporate in our days and interactions the awareness of how we are feeling, let us show up in our day, and be given the permission to feel, process, and express our emotions so that we can then do the same for our colleagues and patients. Let’s sprinkle these opportunities in our days, activities and meetings so that it is no longer a small part of what we do but becomes the essence of who we are in health care.

Let us bring back the basics of our humanity. Robots have a role, but let them continue to assist us, not replace us.