"Medical processing" - our failure to deal with suffering

     Why do we systematically avoid the personal and human dimensions of our patients' - and our own - suffering?

Recorded medical appointment:

     The doctor greets the patient, a middle-aged man, inviting him to sit. He says he now has recovered from what was probably just an infection. The doctor turns to the computer, nodding occasionally while attending to the screen. 

     The patient suddenly speaks up: 'I have really been physically healthy all my life, right until my wife died three ... three years ago. Three years ago.' 

     The doctor looks at her computer, showing no reaction: 'Yes.' 

     Patient: 'And ... and then a great deal seemed to happen ... and so the last three years there has been a lot concerning my heart and so, but ... otherwise ... I guess I am ... relatively ... ' 

     The doctor: '... But otherwise you have been healthy, yes?' 

     Patient: 'Yes ...' 

     The doctor pulls her chair over to the patient and smiles: 'Then there is the big question that is asked of everyone who comes here: Do you smoke?'

       Agledahl KM, Gulbrandsen P, Forde R, Wifstad A. Curteous but not curious: how doctors' politeness masks their existential neglect. A qualitative study of video-recorded patient consultations. J Med Ethics 2011;37:650e654.