He was a young man, struck head-on by a drunk driver. He arrived conscious and breathing, always good signs in major trauma, but the rapid progression of a complete white-out on his chest x-ray in the ER spoke to a bad prognosis.

I knew he would die. My next patient was a small obviously well child, whose mother was upset that she had waited too long for care, and let me know about it. I came very close to blowing up at her. I wrote about him once before.

We face multiple levels of severity in patient care every day. Family medicine and emergency care are most emblematic of that to me, because they are what I practiced. We reassure someone about a minor transient problem from which they will quickly recover, and walk into a room to tell someone they are facing death from the recently diagnosed cancer. Then, we walk on to a well-baby check, a happy cooing baby surrounded by new parents.

We try to cushion ourselves from that emotional roller coaster, and we are cautioned against becoming too emotionally involved with patients so we can preserve our objectivity. But it is hard to switch our emotions on and off, and sometimes it shows. It can be a source of stress, especially when the patients are angry or stressed themselves.

The news about a police officer who threw a young woman to the ground is all over the news. The usual pundits are weighing in on both sides.

His actions are now being blamed on his emotional state from being involved in two attempted suicides (one successful) and the subsequent emotional burden the officer carried as he dealt with an apparently angry young woman who refused to comply with his orders. How many of you have felt like throwing a patient to the ground?

There are some who say it is OK to become a little emotionally involved with our patients. They say we should not be automatons who have no feelings.

Others say that is bad because we run the risk of too much attachment, so much that it could cloud our judgement, and interfere with our ability to make decisions in the best interest of the patient.

There is opportunity to care about patients, and for me, I loved patient care because I cared about the patients I got to know. But not too much, right?

But what about anger? How do you handle your anger?

What do you do to blow off steam? How do you decompress or prepare for the next patient after you’ve had a particularly stressful visit?

Is it right for us to “soldier on” and “suck it up” after a bad encounter? How do you prevent it from affecting your next encounter?