Shedding tears with patients no longer taboo

Knowing when it's appropriate to cry in front of patients is still a tricky subject for doctors.

By Amy Snow Landa, AMNews correspondent. Jan. 23, 2006.

In the movie "A League of Their Own," a member of a women's professional baseball team in the 1940s becomes upset during a game and begins to cry.

Tom Hanks, as the team's crusty manager, reacts with disbelief and disgust: "Are you crying? There's no crying in baseball!"

But is there crying in medicine?

Certainly, the practice of medicine can move physicians to tears. But doctors often refrain from shedding them in front of patients or colleagues.

"Traditionally, physicians are trained that tears are unprofessional and represent a kind of professional weakness," said Rachel Naomi Remen, MD, a clinical professor of family and community medicine at the University of California, San Francisco School of Medicine and the best-selling author of Kitchen Table Wisdom: Stories That Heal.

For years, the model of a "good doctor" has been a physician who remains calm and dispassionate, said Howard Brody, MD, PhD, a professor of family medicine and director of the Center for Ethics and Humanities in the Life Sciences at Michigan State University.

That model works well in acute, crisis situations when a physician needs to remain calm in order to be effective and to reassure the patient, Dr. Brody said. But, he said, some physicians go too far in thinking "that any display of emotion is unscientific and bad and that it harms the patient."

Moreover, some doctors use emotional detachment to protect themselves from their feelings, he said. "They didn't ask if it's good for the patient to be cold and distant. They asked: 'Is this comfortable for me?' "