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To Cry or Not to Cry? That is the Question
~Norman T. Reynolds, MD, Distinguished Life Fellow of the APA

“Those who do not weep, do not see.”
― Victor Hugo, Les Misérables

I entered medical school at age 20, and now I am over 70 years old. In that span of over half a
century, I have never, ever seen a doctor cry. I have never heard a doctor talk about feeling like
crying. It never occurred to me to ask, “How I should handle such feelings?” Instead, I wanted to hide
my feelings and pretend I did not have them. I was ashamed. I thought there was something wrong
with me that I had such feelings in my role as a professional. I saw myself as less than, as inferior,
defective for even having such feelings.
As an intern assigned to pediatrics, I attended children who had terminal illnesses. I recall watching
the life drain out of a boy undergoing treatment for leukemia. On nights that I was not on call, I
would get down on my knees before getting into bed and pray (something that I did not routinely do,
or more accurately rarely did). I pleaded to God to let the boy die that night when I was not on call.
Why? I was afraid. If he died on my watch and I had to pronounce him dead and interact with his
parents, I knew I would tear up, perhaps lose my voice, or even breakdown and cry. Well, thank God,
he did die on a night that I was off. However, thereafter, I was still in a quandary. What was I to do to
acknowledge his passing? I knew I could not talk in person to his parents because, again, I might cry.
I decided to write his parents a letter of condolence. In the wake of his death, none of my coworkers
(including me) talked about him or how to express ourselves to the family. There was no discussion
of our feelings of sadness and loss and how to respond. Could we do things that ordinary human
beings do, like go to his funeral service, or send a card, or send flowers?
The boy passed, his room was cleaned, and we were onto our next patient—business as usual. In
saying this, I don’t want to imply that he was not treated by the physicians and staff in a caring way
because they did. But, discussion of feelings was an unspoken taboo. Physician feelings of sadness,
grief, and mourning were taboo topics, as if such feelings didn’t exist. How did this experience affect
me? Previously, I had considered pediatrics as a field of specialization. I like children. However,
given my emotional make up, I decided that I could not become a pediatrician. I did not fit into the
culture of my colleagues. Obviously, I was not emotionally strong enough.

Over subsequent years, on my own, I developed a different perspective. About a year after entering
practice as a veterinarian, my daughter called me on the phone one night and said: “Dad, I am in
trouble. I might lose my job.” She had been the vet for a family whose pet dog eventually had to be
euthanized. At a final gathering, the two young children were overcome with grief. In response, she
hugged them, and then she teared up. She told me that as students, she and her classmates had
been explicitly told not to show such emotions. I responded: “People know instinctively when you are
crying for yourself and when you are crying for them. If your colleagues can’t see that, they don’t
deserve to have you.” The comforting words of a father were not enough to erase the fear.
Of course, neither the family nor the support staff registered a complaint against her. On the contrary,
a month later, a large bouquet of flowers arrived at the clinic with a card addressed to her thanking

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NORTHERN CALIFORNIA PSYCHIATRIC SOCIETY Page 15 JANUARY/FEBRUARY 2022