On Doctors and Emotional Labor

A recent post on this site about stress among health care providers reminded me of some recent work in my discipline on the sociology of emotions. Research in this area has shown how occupations often include “feeling norms” about how practitioners should manage and display appropriate emotional states as part of their job.

During my prolonged treatment for acute myeloid leukemia, I witnessed one such “feeling norm” on the part of several of my doctors.

In the early stages of my treatment, I received induction chemotherapy and was exploring my options for further treatment, including a stem cell transplant. During this time, I met with several oncologists. They were professional, clinical and informative in our interactions, but they also maintained emotional distance or neutrality.

This changed in the later stages of my treatment, after I had my transplant and it appeared I was on the road to recovery with no serious complications. Those same doctors became much more emotionally expressive, and our interactions had a warm, nurturing quality that had been notably absent before then.

My intuition is that this shift reflected an unspoken feeling norm about how doctors manage and display emotional states. Bluntly put, they were reluctant to make an emotional investment when their patient was still facing uncertain outcomes. Once my odds of survival had qualitatively improved, they allowed themselves to activate and convey a much stronger emotional bond with me.

It’s worth noting that these oncologists were also all women, so gender norms were certainly part of the dynamic. Nonetheless, this pattern of initial emotional neutrality giving way to subsequent emotional connection seems like a highly adaptive and relatively healthy way for doctors to deal with the unpredictable and sometimes tragic outcomes of cancer treatment.

This pattern was not as pronounced with my nurses, who displayed more emotional availability from the outset; that’s a subject for my next post.