Temerty Medicine Alum: On Holding Space for Emotions and Breaking the ‘Rules’

I walked into my 30-something year old patient’s room a few hours after an unsuccessful surgery.  I knocked softly on the door and opened it in trepidation. He lay in his bed as his sister fussed around with the blankets that covered him. All I could hear was the beeping of the monitors and my own heartbeat.

“Unfortunately the cancer has spread throughout your abdomen. There were no surgical options to relieve the obstruction.”

He blinked a few times, letting the news settle in. At that moment, I looked over at his sister, his main caregiver, who was usually so optimistic and stoic. Her face crumpled. Instinctively she reached to me for a hug and, for the first time, I cried with a patient.

I was furious with myself. How unprofessional! As shame washed over me, I quickly wrapped up the conversation and left the room.

I was raised by a general surgeon, like myself. The rules my dad drilled into me were simple: work two times as hard, be three times as friendly and never show your emotions at work. As a Black woman in medicine, especially surgery, there are no opportunities for mistakes — and I had made one.

The rules were formed by my father’s own struggle for preservation in medicine where he was treated differently as a Black surgeon in an all-white space. He wanted to protect me from a field where stoicism is rewarded and expressions of sadness or frustration are viewed as a fault.

Five years after that patient encounter, I sat in my therapist’s office discussing my overwhelming lack of engagement and how I felt as though I was becoming increasingly less expressive. I realized my father’s rules had formed an armor that were no longer protecting me. Rather, they had become harmful.

I was burnt out. I had been functioning in a system where my authentic self was being suffocated.

Doctors are notably susceptible to mental health issues such as anxiety, depression and suicidal ideations. A survey published by the Canadian Medical Association in 2018, found one in three physicians experience signs of depression and burn out. And data from the United States shows racialized physicians have the compounding effects of microaggressions, leading to erosion of self-esteem that dampens the trajectory of racialized physicians in academic medicine and leadership.

Although strides have been made in the last few years to humanize physicians and bring awareness to their mental health, the burden is still on us to create our own strategies for resilience instead of addressing the organizational issues that lead to physician burn out.

I’ve found mindful meditation can help, as does a good therapist, but they cannot root out systemic racism or sexism in medicine.

A few years ago, I had the privilege to be my dad’s main caregiver as he slipped away from pancreatic cancer. In those moments watching the slow drip of his IV, I sometimes wished a physician would come into the room and bear witness to the emotional toll of his disease.

Treating sick people day in and day out comes with a heavy emotional price tag. It is one of the grueling aspects of being a physician — holding space for our own emotions as we help our patients navigate theirs. We need systematic changes to medical education that do not strip us of empathy and compassion.

It is not easy work, but it makes us not only whole physicians but whole humans. And if that’s what showing our emotions will allow, maybe it’s time we start making new rules.

Dr. Mojola Omole (MD'07) is a breast surgical oncologist and a general surgeon practicing at Peterborough Regional Health Centre, as well as a board member of the Black Physicians Association of Ontario.