Does admitting vulnerability have to be a bad thing?
I remember a patient I looked after several years ago. She had been admitted to a general paediatric ward with the medical complications of her eating disorder. The idea of nasogastric feeding terrified her. She sat sobbing on her bed. Although I never needed artificial feeding when I had anorexia, I could totally 100% relate to what this girl was going through.
It was a strangely quiet night shift. I had the option of getting some sleep but instead I sat with the girl and we chatted. She cried- I held her. She talked- I listened. As I left the room she said “Nobody has ever got it like that before. Thank you”. The following morning her mother came to find me. She was so grateful for the time that I had spent with her daughter but she had seen through my empathy. “You understand in a way that others don’t, like you know what it is like. Have you had a sister with it or something?”
In that moment I didn’t know what to say. I worried I had crossed the boundary of professionalism, thought I would get into trouble. I don’t even have a sister… I could make one up…… But somehow honesty was the only way. And so I explained that I had suffered from anorexia as a teenager, that I had been in hospital for 3 months and that things had been tough. But I could also tell her that I had come out the other side and now had a healthy relationship with food. The mother looked at me and tears started rolling down her cheeks. I immediately regretted what I had said. She unexpectedly leant forwards and hugged me. Into my ear she whispered “Thank you, thank you so much for giving me hope.”
Admitting vulnerability doesn’t have to be a bad thing.
Opening up with patients
All too often in the healthcare sector, we refer to vulnerability as a negative attribute. We are expected to pick ourselves up, brush ourselves off and get on with things. Stigma silences us. In their study, Malterud and colleagues demonstrate that vulnerability can be beneficial in the doctor patient relationship.
Clearly there is a boundary when it comes to sharing our own struggles with patients. After all, we remain the professional in the relationship and as such, need to be aware of how the disclosure may impact on that. Revealing insecurity doesn’t have to be done by spelling things out though. Thoughtful questioning and understanding can be sufficient to help the patient feel valued.
However, opening up can leave us feeling exposed. I was convinced that I would get into trouble for my behaviour. I worried about it for days. What if someone at work found out? What if they thought I could no longer be a good doctor?
It turns out nothing happened. Of course it didn’t. I did nothing wrong. Being true to ourselves isn’t always such a bad thing.