When we talk about justice, equity, diversity, and inclusion (JEDI) in healthcare, the conversation often stays at the intellectual level. We understand that JEDI work is crucial and that it is the right thing to do. Yet we rarely talk about JEDI at the emotional level.
When I think of JEDI, the emotions that usually come up are anger, frustration, and indignation. I feel angry when patients tell me they have been mistreated because of stigma around mental health and substance use. I feel frustrated when patients cannot access the treatment they need. I feel indignant when I see how differently governments respond to public health emergencies—COVID-19 and the toxic drug crisis— in terms of policies, resources, and urgency.
But as I reflected more deeply, I noticed other emotions that I rarely talk about. I felt sad when a patient told me about the trauma they experienced in residential school. I felt shame when I misgendered a patient. I felt small and scared when a patient said they didn’t want an Asian doctor.
I believe that, to advance JEDI in healthcare, we must go beyond the intellectual level. We must speak to each other’s hearts. We need to move beyond the more obvious and socially acceptable emotions, such as anger and frustration, and make room for deeper, more vulnerable, and more uncomfortable emotions, such as sadness, shame, and fear.
When I was working on my master’s thesis, I discovered a concept called professional alexithymia. It describes how medicine has a culture that often “address[es] the emotional realm through ignoring, detaching from, and distancing from emotions.” Medical training did not teach us how to notice, explore, or share our emotions. On the contrary, this was often discouraged so that we could remain “objective” and “efficient.” We learned to move on from one patient to the next.
I am still learning about my emotions, and it has been a fascinating journey. For example, when I learned, while reading Atlas of the Heart, that there are 87 emotions, it blew my mind!
My hope is that we can collectively foster spaces in medicine where we can be vulnerable and human with each other, particularly when it comes to the more challenging and uncomfortable emotions. I believe these spaces are foundational to JEDI, physician wellness, and better patient care.
After all, behind our stethoscopes, we are all human beings.
References:
Brown, B. (2021). Atlas of the heart: Mapping meaningful connection and the language of human experience. Random House.
Shapiro, J. (2011). Perspective: does medical education promote professional alexithymia? A call for attending to the emotions of patients and self in medical training. Academic medicine, 86(3), 326-332.