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by Brett Linzer

Thirty years ago I entered Loyola Medical School and my initiation into the culture of medicine began. As best as I could at the time, I prepared myself for the challenges ahead. I aimed to cultivate a strong will, powerful intellect and what I hoped would be enough emotional maturity to succeed. I did not have any family connection to medicine but I knew our society had certain expectations of me in my role as a medical professional. What I did not know is that during my training I would have to develop a persona to hide my inner sense of insecurity and sensitivity.

This persona was like a mask that enabled me to project a sense of confidence, knowledge, and strength to the people around me. It also allowed me to elevate myself and hide the deep sense of inner shame I carried within me. In this culture of medicine, which emphasizes head-based energies and focuses on competition, rationality, and science, my intellect would become master and my heart-based energies of empathy, compassion, connection, and acceptance had to be adapted and concealed. To conform to the norms of medical training, I felt compelled to suppress my heart-based energies and focus my attention on the development of my mind.

This learning was driven home forcefully one day on my third year rotation on General Surgery. I was taking care of a man in his fifties with pancreatic cancer who needed extensive abdominal surgery. I was the first to see him every morning and sometimes our conversation turned to his family. He had a wife and two teenage daughters and was concerned about the effect of his illness on them. One morning, on rounds with the surgical team, I expressed genuine sadness and grief that I was holding for this patient and his family. The senior resident stopped rounds and humiliated me in front of everyone, stating clearly, “We are technicians. We do not allow feelings and emotions to compromise our solid judgment. Your feelings do not belong here. What will make you a good physician is your strong intellect, confidence, power, sacrifice, and hard work.”

I struggled with what that resident said and did to me. I questioned the validity of his words. That experience left an emotional scar of shame and isolation that I still tend to 27 years later. I desperately wanted to be a physician and conform to the customs and values of the successful physicians I aspired to be like. It was difficult for me to abandon my heart-based energies of emotions and feelings and so I developed adaptive patterns of behavior to succeed. I tightened the mask and put on another layer of armor around my heart and I settled uncomfortably into my persona of competence and self-assurance.

Reflecting on my life, from an early age of four or five years old, I had been practicing similar adaptive behaviors. In my childhood environment of fear and uncertainty, strong emotions were not allowed and vulnerability was shunned. In the chaotic environment of not belonging, I developed a strong, independent spirit and took responsibility for myself and others around me. External achievement and competition was rewarded and encouraged. These behavior patterns enabled me to conform to my family system and proved useful in conforming to the rigors of the medical system.

Unfortunately, three of my friends seemingly couldn’t navigate the complexities of the medical culture and chose to end their lives. One of them was my chief resident. His death was especially difficult for me because I saw him as a mentor and a type of physician that I aspired

to be. He had a strong mind and elevated status. I imagined that he had all the answers, but he still took his own life. Now where would I look for answers, for a role model to follow?

In time it became difficult for me to differentiate what was me and what was my persona. A deep inner tension began to develop and I realized I was putting my relationships and possibly even more at risk. These adaptive patterns were interfering with my personal and professional relationships and made it difficult to fully connect with my wife, three kids, patients, coworkers, and even myself. People I was in relationship with did not want me to show up with a mask and a persona that protected me from intimacy, connection, acceptance and love.

In 2013, I reached an especially challenging point. I was so focused on my mind and solving problems that I almost had to break my heart in order to know I had one. I remember an especially chilling moment one night when I was sitting alone in my three season room catching up on Epic documentation. For months, I suffered in my attempt to solve my relational problems with my mind-my thoughts, my reason. That night, my attention turned to my three friends who took their lives. Were they trying to solve deep relational problems with their minds, just as I was doing? I could not come up with an answer, and that scared me.

With the help of my wife, I reached out for help and I started working with a physician coach. He helped me to understand my adaptive patterns of behavior and normalized them in the context of the culture of medicine. I was not alone and I did not have an irreparable flaw. He helped me reconnect with my natural feelings of compassion and empathy, especially toward myself. This relationship sparked a decade long journey of self-discovery, revealing the many layers of my personality, and deepening my awareness of the fundamental components of building and maintaining meaningful relationships.

I now know the truth that being a good doctor means to be skilled intellectually and also skilled relationally and emotionally. I hope that my son and his colleagues, who are starting their first year at the Medical College of Wisconsin, can help to reshape the culture of medicine by learning early in their careers how to integrate their head with their heart.

About Brett Linzer

Brett is a husband, father, friend, MenLiving facilitator and internal and pediatric medicine physician living in Wisconsin. He became involved in MenLiving because of a belief that relationships are the key to happiness. In his free time he enjoys traveling, spending time with family, bicycling, hiking and swimming.


  • Randy says:

    Thank you for sharing this. I spent over 20 years in CME (Continuing Medical Education), some of my positions also included GME and Residencies. I often saw first hand how Some ‘seasoned’ physicians did their best to desensitize and dehumanize residents and med students. The attendings who had held on to their compassion often left the teaching hospitals before they became “one of them”. As a consumer of healthcare and caregiver/advocate for my Mom with Alzheimer’s, I had altercation after altercation with Residents AND Attendings who treated my Mom so dismissively and just a Patient # (ironically at the hospital where I was born and began my CME career, where in one instance I followed the Attending, Residents and Med Students out of my Mom’s Room following a stroke, and screamed “SHOW HER SOME MOTHER FUCKING DIGNITY!! Every patient you see is someone’s Mom, wife, sister, Dad, son, brother. DON’T FORGET THAT!” While the Residents and Med Students picked they’re jaws up off the floor, I turned and went back to my Mom’s Room. Later, the Nurses who witnessed my smack down came up and thanked and congratulated me for saying and doing what they couldn’t. My mantra was AND continues to be, “What about the poor souls who don’t know they CAN question the care and treatment they’re receiving and/or don’t have advocates?
    In the U.S, we don’t have Healthcare. We have HELLthcare. I’m again fighting it firsthand for myself as a cancer patient at a major University Hospital. I’m grateful for the physicians like you. I only wish there were more like you.
    When I was Director of CME at U of IL at Chicago College of Med, I had plans to develop and offer an elective course on “Physician as Creative Writer”, where they’d read non-academic, non-scientific works of physician writers, fiction and non-fiction (though I was mostly reading non-fiction). The goal was to give something outside of the rigors of Med School, and let them use their Right brains and see there was more to them than solely patient care.
    Thank you for reminding me that some of the “good ones” are still here, fighting the good fight.

  • Dear Brett,

    Thank you for writing this. I am glad you are available to me as a facilitator in MenLiving and as a friend. I have felt your compassionate vibe in your hosted Full House meetings, and you always bring me a sense of true connection.


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