A general feeling of well-being can put vital signs in balance. Moreover, Remen and like-minded colleagues firmly believe that tending to patients' inner world, as well as their own, is critical to physicians' and nurses' own mental health. Indeed, more and more doctors and nurses these days are feeling demoralized, overworked, and underappreciated. But lately healthcare providers also are increasingly worried that they are losing control of medical decisions for the sake of the bottom line, and that they don't know their patients as long, or as well, as they used to. A survey called the Physician Burnout Project conducted in California in 1997, for example, found that 40 percent of physicians were clinically depressed and that most had thought about leaving their profession at some time during the previous 12 months.
Medical training is partly to blame.
It can foster a cold, clinical objectivity, often at the expense of basic humanity. Remen remembers responding quickly and accurately as a medical student to an attending physician's questions about why a child died, while forgetting for 45 minutes to talk to the parents out in the waiting room about the child's death. It happens early. By the end of the first year, memorizing biochemistry begins to consume students. To try to change that, Remen and a dozen like-minded colleagues at UCSF ask students to talk about why they entered medicine and to explore death and disease as mysteries that science cannot always manage or explain.