From the July 7, 2023 issue of the Transformational Times
Emotions Need Space: A Physician-Mentor’s Message to Medical Students
Brett A Linzer, MD
Dr. Linzer, a practicing physician in Oconomowoc, WI, has medical students rotating through his office to learn and observe. He encourages students to "let go of the mask and persona" and allow "their vulnerable and emotional selves to emerge." Now that the academic year is in full swing, he offers a story and some solid advice ...
I have had the privilege and honor of coaching and mentoring medical students for 21 years.
Most of this mentoring takes place in my outpatient Internal Medicine / Pediatrics practice, where each student spends two to three days with me every week for a month-long rotation. Additionally, I have been fortunate enough to work with students from all years as a facilitator in the REACH and 4C Coaching programs. Throughout these experiences, I have accumulated over 16,000 hours of one-on-one time with students in my clinic, fostering deep connections and intimate relationships.
During extended periods in my clinic, I encourage students to shed the facade of a medical student who must appear knowledgeable, confident, and unemotional. I ask them to remove their white coats and approach patients with just their name tag and stethoscope. Over time, I help them feel comfortable enough to let go of the mask and persona they wear, allowing their vulnerable and emotional selves to emerge. Gradually, I witness them soften their demeanor, speak more thoughtfully, take time between their thoughts, and smile more often. This process nurtures the growth of trust and connection.
What students tell me
One question I make a habit of asking each student: What is the most challenging aspect of medical school for you?
Sometimes, their responses revolve around academic difficulties, fear of missing an important diagnosis, or lack of sufficient knowledge. However, with patience and gentle encouragement, we often arrive at deeper and more meaningful answers. They share personal struggles such as balancing academic responsibilities with a sick family member, coping with depression and anxiety, feeling isolated, perceiving everyone else as having it all figured out, grappling with imposter syndrome, or struggling with intense emotions following traumatic experiences.
While I don't possess all the answers to these challenges, I believe that empathizing with their experiences and being present for them is helpful. In some small way, I hope that by being there for them, they will feel less alone and broken, just as I once did.
I have discovered that fostering trust and openness requires me to lead by example, demonstrating vulnerability and openness in my own journey. I like to share personal stories. Some highlight my successes and achievements, but the most impactful and relatable tales are those where I made mistakes or faced emotional challenges.
A patient and an interaction I will never forget
One such story, which resonates with many, revolves around my experience as an early third year medical student during my first inpatient rotation. Filled with enthusiasm and a desire to please, I was part of a team that admitted a middle-aged man with a new diagnosis of pancreatic cancer. Before rounds each morning, I would talk with this patient as I gathered the clinical information and performed a short physical exam. He shared details about his family and teenage children. I knew he had a grim prognosis and I felt fear and sadness for him and his family.
One day, during rounds with our team, I allowed a glimpse of my emotions to surface.
The response I received from my senior resident affected me for many years. He stopped rounds, directed his attention at me, and loudly proceeded to publicly humiliate and shame me, declaring that physicians must remain clear-headed and unemotional, detached from their emotions to ensure patient care is unaffected. He demanded to know whether I understood what he was saying. I looked down, softly said yes, and experienced some relief when he resumed rounds.
In the following days, I pondered the true essence of being a doctor. The residents, including my senior, served as my role models and cultural leaders. I questioned whether abandoning my emotions was the right path or if there was room for both intellectual clarity and emotional compassion. It seemed like I had to make a choice between their perspective and my own. After all, they were experienced physicians, while I was only an aspiring one.
As I advanced in my training and subsequent practice, I suppressed and numbed my emotions, seeking refuge in my intellect and self-shaming whenever strong emotions arose. Unfortunately, this approach complicated my relationships with myself, my wife, my children, my colleagues, and my patients.
Finding healing; Learning that emotions need space
In 2013, during a particularly challenging phase in my life, I sought guidance from a physician coach. Through this experience, I discovered that many of my behavioral patterns and subsequent emotions were a direct result of my medical conditioning. More importantly, I realized that I wasn't broken or alone. Emotions, I came to understand, are an integral part of being a complete human being and a successful physician.
I also recognize the significance of finding and creating a dedicated space to process intense emotions. While the acute setting of the ICU or the fast-paced emergency room may not be suitable--clear-headedness, decisiveness, and control are paramount--I needed to look elsewhere.
I found this space among trusted friends, coaches, my wife, and circles of supportive peers. This space, characterized by trust, uncertainty, and honesty, allows me to fully experience intense emotions such as self-doubt, sadness, self-judgment, shame, as well as the joy of living a fully engaged life.
As physicians and medical students, we willingly put ourselves in situations where people may face their most challenging life experiences, relying on us for assistance and support. This work holds profound meaning for me, but it requires intentional effort to acknowledge and process my own emotions. Only then can I consistently show up as a grounded, clear headed, open-hearted, and supportive presence for my patients, family, coworkers, and myself.
My advice: Find mentors and embrace your humanitiy
As you embark on your own journey as medical students and future physicians, it is crucial that you find your own path. I encourage you to seek out individuals you trust to accompany you along the way, whether it be a therapist, a friend, a support group, a physician mentor, a coach, or someone else.
You need a space where you can fully embrace your humanity. The culture of medicine is changing, but not fast enough. There are still numerous role models who resemble the resident I mentioned earlier. I hold compassion for that resident and hope he found a path of healing.
The journey is not easy, and even after 30 years in medicine, I continue to learn and grow.
If you are looking for a space to write about your emotions or your experiences, please consider reaching out to me by email. I promise you I will read it and respond. I would be honored to connect with you.
Dr. Brett Linzer, MD, is an Internal Medicine/Pediatrics physician in Oconomowoc. Additionally, he serves as a coach specializing in guiding medical students and physicians to embrace their complete humanity in both their personal and professional lives. He can be reached at balinzer1@gmail.com