Doctors, Compassion, and Chronic Illness

Dear Dr. H.:

I saw you in the clinic on Friday August 15th. You probably forgot me as soon as I walked silently out the door. But I have not had the luxury of forgetting, because I am still suffering. The specialist you referred me to can't see me for 2 weeks.

Have you ever been ill, Dr. H.? If you can't sincerely say, at the very least, "Gee, I can see you're in a lot of pain. You must feel awful," then you don't belong in medicine.

I entered your room in agony, and was openly crying while you examined me. Yet you conveyed no sense of compassion, no verbal or nonverbal sign that you even recognized my despair. I left more miserable than when I arrived.

Let me assure you that your conduct is not at all extraordinary. On the contrary, I am writing because behavior like yours is altogether too common. I have decided that I will no longer tolerate it in silence. From now on, I intend to try to raise the consciousness of those who are supposedly "caring" for the ill.

Let me give you the benefit of the doubt, Dr. H. Perhaps you weren't given any training on dealing with the chronically ill. So think of this letter as a bit of continuing education. When a patient announces that they've had continuing physical problems since birth 40 years ago, it helps to show some human response, such as saying "That's a long time to feel sick, I'm sorry to hear that." A blank stare really doesn't help as much as you may have been led to believe.

When a patient is clearly in misery, it is important to acknowledge that fact. To be invisible makes illness more painful. If you cannot alleviate a patient's problem, at least offer the sincere wish that you could do more to make them feel better. In my opinion, it's a matter of simple human decency. Most people would treat a dog caught in the rain with more sympathy than you had for me that day.

When you pretended that your referral to a specialist was all I needed, you hurt me terribly. You denied that I was in pain NOW. Did you hear me when I said I'd been suffering even more than my usual amount, every day for two weeks, and was at the hospital because I had reached my limit of endurance? When a chronically ill person says that they have reached the limits of their endurance, that means they are in an emergency situation. A chronically ill person's limit is forced to be much higher than a normal person's, so if a chronically ill person can't take it anymore, then that should be a signal that something is wrong. Unfortunately, to you it's not an emergency unless there's blood spurting and the person is unconscious.

Perhaps only when patients take their "business" elsewhere, will health-care providers have the hindsight to realize that the "customer" should have been treated with some dignity and respect. For the $200 I pay in health insurance every month, I would think I could get at least get a little kindness.

Is that too much to ask?

-- Shelley

Posted to the Eczema Mailing List

Date: 9 Aug 1997
From: Shelley Diamond

Shelley has served as the Network Leader for the SF Bay Area Psoriasis Support Network.

Please also see her Case Story: Lifelong Effects of Chronic Atopic Eczema

Oct 2006 update:
Shelley went to graduate school and is now a licensed psychologist in private practice doing psychotherapy in San Francisco. Please visit her website:

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