Managing emotions in medical school: Students' contacts with the living and the dead.

Professionals are not supposed to feel desire or disgust for their clients, and they presumably begin to learn "affective neutrality" in professional school. Medical students learn to manage the inappropriate feelings they have in situations of clinical contact with the human body, but two years of participant observation revealed that the subject of "emotion management" is taboo. Yet the culture of medicine that informs teaching also includes a hidden curriculum of unspoken rules and resources for dealing with unwanted emotions. Students draw on aspects of their training to manage their emotions. Their emotion management strategies include transforming the patient or the procedure into an analytic object or event, accentuating the comfortable feelings that come from learning and practicing "real medicine," empathizing with patients or blaming them, joking, and avoiding sensitive contact. By relying upon these strategies, students reproduce the perspective of modern Western medicine and the kind of doctor-patient relationship it implies.

[1]  E. Freidson.  The Profession of Medicine , 1923 .

[2]  M. J. Daniels.  Affect and Its Control in the Medical Intern , 1960, American Journal of Sociology.

[3]  Howard S. Becker,et al.  Boys In White , 1961 .

[4]  T. Hunter.  Boys in White , 1962 .

[5]  Charles Kadushin,et al.  Social Distance Between Client and Professional , 1962, American Journal of Sociology.

[6]  H. Lief.  Training for 'detached concern' in medical students , 1963 .

[7]  M. Foucault.  The Birth of the Clinic , 1963 .

[8]  M. Haug,et al.  Professional Autonomy and the Revolt of the Client , 1969 .

[9]  J. W. Mudd,et al.  Sexuality--the experience and anxieties of medical students. , 1969, The New England journal of medicine.

[10]  S. Papper.  The undesirable patient. , 1970, Journal of chronic diseases.

[11]  D. Lipsitt.  Medical and Psychological Characteristics of “Crocks” , 1970, Psychiatry in medicine.

[12]  J. Krantz,et al.  The birth of the clinic. An archaeology of medical perception , 1975, Medical History.

[13]  G. L. Engel.  The need for a new medical model: a challenge for biomedicine , 1977 .

[14]  W. Shaffir,et al.  The Professionalization of Medical Students: Developing Competence And A Cloak of Competence* , 1977 .

[15]  A. Hochschild.  Emotion Work, Feeling Rules, and Social Structure , 1979, American Journal of Sociology.

[16]  J. Hammond.  Biography Building To Insure The Future: Women's Negotiation Of Gender Relevancy In Medical School* , 1980 .

[17]  Y. Tuan,et al.  Segmented worlds and self : group life and individual consciousness , 1982 .

[18]  A. Hochschild.  The Managed Heart , 1983 .

[19]  R. Gorlin,et al.  Physicians' reactions to patients. A key to teaching humanistic medicine. , 1983, The New England journal of medicine.

[20]  S. Kleinman.  Equals Before God: Seminarians As Humanistic Professionals , 1984 .

[21]  C. A. Bowers,et al.  The Promise of Theory : Education and the Politics of Cultural Change , 1984 .

[22]  K. Black,et al.  Sexual Equality: The Israeli Kibbutz Tests the Theories. MICHAL PALGI, JOSEPH BLASI, MENACHEM ROSNER, and MARILYN SAFIR (Eds.). Norwood, PA: Norwood Editions, 1983, 337 pp. (+ xiv). $27.50. , 1985 .

[23]  P. Thoits,et al.  Self-Labeling Processes in Mental Illness: The Role of Emotional Deviance , 1985, American Journal of Sociology.

[24]  B. Tabachnick,et al.  Sexual attraction to clients. The human therapist and the (sometimes) inhuman training system. , 1986, The American psychologist.

[25]  S. Kleinman,et al.  Emotions, Reflexivity, and Action: An Interactionist Analysis' , 1988 .

[26]  E. Sampson.  The debate on individualism: Indigenous psychologies of the individual and their role in personal and societal functioning. , 1988 .