| This study is based on the difference between the emotional experience of body contact in the personal world and the ideals of medicine which suggest that many emotions imply a failure in the physician. The medical student expects to learn a professional perspective which will eliminate feelings considered natural, if not always pleasant, during body contact before entering medical school.;Comfortable feelings reported include excitement at beginning real medical training, a sense of attaining understanding in combining abstract and concrete knowledge, and a sense of gaining the privilege and power of the physician. Uncomfortable feelings included apprehension of the "mad scientist" image, a sense of violating taboos, philosophical confusion, sexual arousal, and disgust. Students reported a concern that they would become "de-sensitized" too generally in becoming "macho" enough to work effectively. Individually, they managed discomfort using three strategies: intellectualizing the body, mentally transforming the body into something non-human, and minimizing sensitive contact. All three strategies are directly supported by characteristics of the curriculum. Students reported that discussion of their experience is limited to close friends and exceptional faculty members. They recognize subtle indicators that other students share the problem, but often believe that others handle it more adequately.;The study concludes that uncomfortable feelings continue through the first three years of medical training, but that the emotion management strategies serve effectively in reducing discomfort. The author suggests that unless the students develop flexibility in the use of their strategies they will adopt a stance which minimizes the psychosocial aspects of medicine.;To describe the student's feelings during clinical body contact, and his attempts to manage them, the study was based on a naturalistic design covering a two year period (1984-1986) and the first three years at one medical school. Interviews were conducted with 44 students and 18 residents, attendings and nurses. A total of 168 hours of observation were conducted in the anatomy laboratory, the physical diagnosis course and the five third-year clerkships. Findings were validated through review of a draft report by students, residents and faculty. |
