Timothy E. Quill, MD; Robert M. Arnold, MD; Frederic Platt, MD
Acknowledgments: The authors thank the American Academy on Physician and Patient and the Bayer Institute for Health Care Communication. Both organizations have helped the authors to develop their skills in counseling patients and in teaching the physicians these skills.
Requests for Single Reprints: Timothy E. Quill, MD, University of Rochester Medical Center, 601 Elmwood Avenue, Box 601, Rochester, NY 14642.
Current Author Addresses: Dr. Quill: University of Rochester Medical Center, 601 Elmwood Avenue, Box 601 Rochester, NY 14642
Dr. Arnold: Montefiore University Hospital, 200 Lothrop Street, Suite W932, Pittsburgh, PA 15213-2582.
Dr. Platt: 1901 East 20th Avenue, Denver, CO 80205.
Quill T., Arnold R., Platt F.; “I Wish Things Were Different”: Expressing Wishes in Response to Loss, Futility, and Unrealistic Hopes. Ann Intern Med. 2001;135:551-555. doi: 10.7326/0003-4819-135-7-200110020-00022
Download citation file:
Published: Ann Intern Med. 2001;135(7):551-555.
Physicians who care for patients encounter many powerful and painful emotions, including anger, sadness, fear, grief, loss, hopelessness, and blame. Many studies suggest that physicians should express empathy in response to emotion-laden patient statements to ensure that patients feel listened to and understood. These physician responses usually consist of efforts to comprehend how things feel to the patient and to express that understanding back to the patient (1–8).
Situations that evoke loss, guilt, or hopelessness are particularly hard for physicians to respond to empathically. Physicians who think that they have failed a dying patient and who fear depriving the patient of hope may respond by avoiding the topic entirely, by overcompensating with overtreatment, or by apologizing for not “saving” the patient. When a patient expresses overwhelming anger or disappointment with limitations in medicine, physicians may be afraid that any explicit response to the patient's emotion may be construed as evidence of their failure, mistake, or inadequacy.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only