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fostering the humanistic practice of medicine publishing personal accounts of illness and healing encouraging health care advocacy

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Inner Duality

If you have ever been in therapy, you likely discovered that while you share personal details about your life, the therapist reveals little information about theirs. From my understanding, when and what to disclose is part of a therapist’s training. In contrast, in medicine, relatively little about self-disclosure is taught. Instead, it is up to the individual to figure it out on their own.

As a family physician, I frequently consider when and why to self-disclose personal information. If a patient is nervous about an upcoming procedure which I have undergone, do I share my experience? If a patient has a parenting dilemma that I have navigated, should sharing be part of my empathy? If a medication I am prescribing worked for me, do I reveal this as encouragement?

Sometimes parents ask me direct personal questions. For example, “Have you been through menopause?” Or “are you a parent?” Or “Have you gotten your COVID vaccine?” I use self-disclosure as a tool to build relationships, allay patient fears, and normalize situations, always questioning myself carefully before I share, to make sure I’m not disclosing information to meet my needs.

Patients are curious about, and care about, their providers. As perceptive people, they are notice when we seem “off”—tired, sad, without our usual spark. There is a note of compassion as patients ask if I’m okay. I may reply that I did not sleep well or am having a busy week. After a sudden absence when my father died, I shared pieces of my news. But I still felt the need to reassure my patients that I was all right and in control.

Since Hamas attacked Israel on October 7, 2023, like most of the Jewish people I know, I am decidedly not okay. The literal and existential threat this war poses to the Jewish people paralyzes me. I fear for loved ones directly and indirectly affected by the violence. I am consumed by social media, news, and commentary, as I attempt to discern where truths lie.

I am living a dual life. In one life, I am a family physician and a medical director at a mission-based health center dedicated to caring for folks who are marginalized and threatened by society. In my other life, my heart is shattered, my mind races, and my tears flow at synagogue in prayer with my community.

It is a tough call these days, to know how to integrate caring for others while inside you’re deeply hurting.

Pamela Adelstein
Newton, Massachusetts


2 thoughts on “Inner Duality”

  1. Yehudit Reishtein

    Self disclosure is a delicate thing– how much dare you share, how much can you absorb of the other’s pain? As an ex-pat American Jew living in Jerusalem now, trying to manage life in a war zone, it is a constant effort to manage my own feelings and experiences, while simultaneously trying to support others who are doing the same. Thank you for sharing your exoerience.

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