The Divided Self in Medicine: Dr. Jekyll, Mr. Hyde, and the Hidden Wounds of Healing

"Man is not truly one, but truly two."
— Robert Louis Stevenson, The Strange Case of Dr. Jekyll and Mr. Hyde

Introduction: Jekyll and Hyde in the Hospital

I still remember the first time I watched someone die. I had just graduated nursing school and been accepted into a competitive ICU residency program. On my second day, one of my assigned patients coded. It was the typical scene. A flurry of alarms, bodies rushing in from all corners, medication flying, the unspoken tension of trying to reverse what everyone already sensed was coming. Somewhere in the chaos, I remember noticing that even before she died, this woman had started to seem less human. Not by any action or intention, just… fading. Maybe, it was how we spoke over her. Or how her body, so recently hers, had become an object of procedure. And then she was gone.

There was a strange emptiness in the room. Everyone dispersed quickly. I helped clean up a bit. Then I ducked into a supply closet, cried for a few minutes, and moved on. There was still another patient to check on, a new admit coming in, a pile of tasks that didn’t pause for grief. No one asked how I was doing. I didn’t expect them to.

That memory lives in me not because of its horror, but because of what it revealed: that in order to function, I had to split myself. One part went on with the charting and the IVs and the answers. The other part (the one who cried in the supply room) was hidden. Suppressed.

And here’s the truth few of us in medicine want to confront: we are not always the heroes of the story. Sometimes, to survive the system, we do what we swore we wouldn’t. We detach, we rush, we stop feeling. We become efficient but distant. Caring turns into performance.

In The Strange Case of Dr. Jekyll and Mr. Hyde, the story has often been read as civilization versus barbarism, good versus evil. But medicine’s version is subtler. It isn’t about evil versus good. Rather, it shows up as caring versus not caring. Both are necessary at times. To care too much can break you; to stop caring entirely destroys you. This is the dualism we all must confront: how to be human in a profession that often rewards inhuman endurance.

Repression and the Making of Mr. Hyde

In Stevenson’s tale, Dr. Jekyll isn’t battling an enemy; he’s wrestling with the part of himself he wants to deny. When he creates Mr. Hyde, it is with the hope that he can compartmentalize, to carry out the respectable life of a physician without being disturbed by darker impulses (Stevenson, 1886).

In healthcare, clinicians are often forced into a similar bargain to partition the parts of themselves that feel fear, sadness, anger, even intuition, in order to maintain a steady, professional exterior. Jung would call this the shadow self: the aspects of the psyche we suppress to meet social expectations (Luster, 2024). From early training, providers are taught (explicitly and implicitly) that emotional suppression is a virtue. One study of medical students found they learned to “inhibit emotional expression to maintain professional composure,” even during distressing encounters like suicidality or death (Doulougeri et al., 2016). The pressure to stay cool under fire reinforces a belief that feelings make you weak, or, worse, unfit.

The cost? Internal fragmentation.

The Quiet Violence of Moral Injury

The concept of burnout is everywhere in medicine, but what many clinicians are experiencing isn’t just exhaustion. We are experiencing moral injury. That is, the psychological distress that arises when you must act in ways that betray your core values (Dean & Talbot, 2018). When a provider is forced to discharge a sick patient due to insurance restrictions, or watch a family suffer because no palliative support is available, they may do what’s “required” but walk away wounded. One emergency physician described it this way: “We are not overworked. We are demoralized. We are spiritually broken” (Hostetter & Klein, 2023).

Moral injury is often cumulative and is a death by a thousand ethical paper cuts. Over time, clinicians carry invisible grief, anger, and guilt. But because those emotions are taboo, they get buried, and that buried self starts to seep out in other ways: detachment, cynicism, mistakes, even substance use or suicide (Dean & Talbot, 2018; Weiner, 2023).

When the Mask Cracks

This emotional division can’t last forever. Suppressed emotions, like Mr. Hyde, eventually find a way to surface. For many clinicians, this looks like burnout: physical fatigue, emotional numbness, and a sense that their work no longer matters (Brazeau et al., 2014). Studies show that repeated emotional suppression leads to empathy erosion and depersonalization, i.e. treating patients as tasks and not people (Doulougeri et al., 2016). And yet, many providers describe how much they want to feel; they just don’t know how to do so safely.

One physician recalled crying in a hospital stairwell after the death of a toddler: “It eats at you… The pain becomes a scar that doesn’t go away” (Wible, 2015). But back on the unit, he had to compose himself, walk into the next room, and smile. This is the cost of emotional silencing. Over time, it doesn’t just damage providers. It damages the system’s ability to care.

Reuniting the Healer’s Whole Self

If moral injury and emotional repression are the problem, what’s the way forward? First, we must name what’s happening. Burnout is not a personal failure; it’s often a systemic betrayal. Leaders must acknowledge this and begin moral repair; thinking and implementing ideas like debrief spaces after codes and including meaningful clinician voice in policy (Hostetter & Klein, 2023). Second, training needs to change. Emotion regulation doesn’t mean suppression. It means learning how to sit with discomfort and process it in healthy ways. Practices like cognitive reappraisal, brief check-ins, and supportive supervision can help providers stay human in inhuman conditions (Doulougeri et al., 2016). And finally, we need cultural permission. To cry. To question. To say, “This patient’s death affected me.” That’s not unprofessional. It’s deeply professional. It honors the human beings on both sides of the stethoscope.

Conclusion

Dr. Jekyll’s biggest fault was that he believed he could divide himself into only good or only bad. Medicine often asks the same of us. We’re told to be endlessly competent, composed, and caring, and… to hold back frustration, grief, or fear as if those emotions make us less professional. But pretending those feelings don’t exist doesn’t make us stronger. It makes us brittle.

The work is not about indulging our “Hyde.” In this context, it’s about recognizing that humanity isn’t a flaw in the profession. Rather, humanity is the foundation of it. When we confront our limits honestly, when we allow compassion to coexist with fatigue and doubt, we act from integrity rather than image. Wholeness in medicine isn’t moral compromise. It’s moral clarity and is the courage to tell the truth about what this work costs when we still choose to care within it.

Healing the divided self isn’t permission to be less ethical. It’s the invitation to be more whole and to practice medicine not as a performance of perfection, but as a deeply human act of service.

References

Brazeau, C. M., Shanafelt, T., Durning, S., Massie, F. S., Eacker, A., Moutier, C., ... & Dyrbye, L. N. (2014). The burnout syndrome in medical students: Exploring the associations with distress, empathy, and attitudes toward patient care. Teaching and Learning in Medicine, 26(4), 344–350.

Dean, W., & Talbot, S. G. (2018, July 26). Physicians aren’t “burning out.” They’re suffering from moral injury. STAT.

Doulougeri, K., Panagopoulou, E., & Montgomery, A. (2016). (How) do medical students regulate their emotions? BMC Medical Education, 16(1), 312.

Hostetter, M., & Klein, S. (2023, August 18). Responding to burnout and moral injury among clinicians. The Commonwealth Fund.

Luster, R. (2024, July 17). The Shadow Self: How Mr. Hyde Operates in Us All. Psychology Today.

Stevenson, R. L. (1886). The Strange Case of Dr. Jekyll and Mr. Hyde. Longmans, Green & Co.

Weiner, S. (2023, March 28). Out of the shadows: Physicians share their mental health struggles. AAMC News.

Wible, P. (2015, March 20). Heart-wrenching photo of doctor crying goes viral. Here’s why. Ideal Medical Care Blog.