by Dr. Iain Corness
The medical dangers of being ‘simpatico’
When I was still in my first intern
year, I scored a posting to Gibraltar, that rocky finger that hangs off
Spain in the Mediterranean. The rock was to be my abode for the next six
months, while I carried out my surgical term, and it was there that I was
exposed to the Spanish adjective ‘simpatico’.
Whilst similar to ‘sympathetic’ in English, it has a much deeper meaning in
Spanish and refers not only to how others see you, but also your own
Now while being considered as ‘simpatico’ would look to be an admirable
characteristic for a young doctor, it was something of a two-edged sword, as
I was to find out later.
The price is a reduction in the doctor’s personal quality time. As you
become more and more involved with the patients, whose needs encompass 24
hours, the young doctor ends up as a slave to not just the patients, but to
However, being an intern is a stressful time for young doctors. Quite
frankly, after graduation and a nice new shiny name badge, you do not know
enough about common conditions, but are expected to have encyclopedic
knowledge by the patients. In my own case, I was quite sure I could diagnose
an adenoma of the pancreas, but I had no idea what to do with a child with
earache. Like many professions you pick it up as you go – but not too many
professions have the ‘life or death’ tag attached.
In case you think that the pressures are not really that bad, after all, the
popular image of the young intern is one of permanently trying to get into
every nurse’s knickers in between bouts of beer swilling at the closest pub
to the hospital, this has to be based on fact, surely. Let me assure you
that the “Carry On” movie series was no reflection of the real medical
world. Being on call for 108 hours a week does not leave much time for
after-hours gynecological studies with Nurse Smith from ICU.
Stress? I can remember one of my consultants telling me that a 24 year old
female patient was going to die because her heart muscle had given out. I
could not believe that this was the case. Surely we could do something?
Unfortunately, all those years ago we could not. Heart transplants were yet
to come. Pacemakers likewise. The consultant knew when to ‘turn himself
off’. Junior Houseman Corness did not. I kept going back to her bed in the
ICU, willing her to live. She was only 24 for Pete’s sake. She died.
The result of such stress on doctors has been studied quite comprehensively,
and the respected New England Journal of Medicine published the results of
the research carried out by the Johns Hopkins University School of Medicine.
The Hopkins team assessed the specialty choices, marriage histories,
psychological characteristics, and other career and personal factors of
1,118 physicians who graduated from the Johns Hopkins University School of
Medicine from 1948 through 1964.
After decades of following 1,118 physicians who graduated from the Hopkins
School of Medicine between 1948 and 1964, researchers found a 51 percent
divorce rate for psychiatrists and 33 percent for surgeons, rates higher
than those for internists (24 percent), pediatricians and pathologists (each
22 percent). The study revealed a 32 percent overall physician divorce rate.
Results also strongly suggest that the high divorce risk in some specialties
may result from the inherent demands of the job as well as the emotional
experiences of physicians who enter those fields. Right! You’re telling me
nothing I don’t know (from bitter experience, I might add)!
The recommendation was, “Marital counseling during residency training
appears to be a good idea for family and career satisfaction in the long
My eldest son, Dr. Jonathan Corness, has the ‘simpatico’ gene and for that
reason I tried to talk him out of Medicine as his future. But when he
decided that being a Radiologist might be a better specialty than
Pediatrics, I applauded his decision. For people like Jonathan, one step
back from the frontline is a good career move. Unfortunately, I stayed at
the frontline too long.
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