Saturday, May 25, 2013

I Should Have

There's something strangely heart breaking in the You Should'ves:

You should've treated the infection sooner!
You should've made the diagnosis faster!
You should've done more!

These words uttered accusingly from a patient's mouth can cut to the core of a physician.  We've all been there.  No matter how rigorous your skills and training, there will be many bad outcomes.  Unfortunately, from time to time, a patient or family will point the finger directly at you.

I don't blame them.  How else to deal with death, destruction, and illness.  Some turn inward.  Some point to the heavens and ask why.  And some look you in the eye and spit venom in your direction.

I always try to step back and appraise the situation as objectively as possible.  I am not infallible.  Humans make human mistakes.  But often, I find, that bad things happen without adequate explanation.  We are both wondrous machines with infinite intricacy and ticking time bombs all at the same time.  If I thought accepting the burden of blame would ease the suffering, I would throw myself under the bus without question. 

We all know this won't undue that which has already been done.

Yet, there is a menace, even more devastating to the psyche of those who have taken such sacred oaths.  I am referring to none other then the havoc wreaked by the I should'ves.  Every physician I know is haunted by the times when their skill fell just a little short, their insight was lacking, or their timing was imperfect.

These are the cases that make you toss and turn through sleepless nights.  These are the faces you carry year after year.

So you walk into the room of the grieving patient or family.  You look these people who love and trust you in the eye, and you tell them of your shortcomings.  Mostly they shake their heads and forgive you quickly.  It's of little consequence that you shamefully accept the comfort they bestow on you.  You will not escape unscathed.

Over the coming months and years,

the wounds you inflict on yourself will do nothing but fester.


Anonymous said...

Wish my old physician had done this. I politely pointed out to him a few mistakes he made and he wouldn't apologize. Wish he took these things to heart like you do. However, he's not the only one in the practice like that.

Unknown said...

It takes a lot of guts to blog what you are blogging. I commend you. I am a nurse who is volunteering at this time (as opposed to working). I agree with you on all accounts. When / if I find a doc locally who will stand up for what you stand up for, but in my area, I will gladly pay a yearly fee, etc. to have their time and break this awful cycle that I've witnessed first hand. And yes, the should'ves are torture.

Sean Martin said...

Great post! It always amazes me how ubiquitous this experience/feeling is among all care providers, and yet you cannot help but feel terrifyingly alone when a "should've" type event happens to you. I received great advice at the beginning of my career, avoid ever saying "I should've..." as it focuses on a past you cannot change. Instead, replace "I should've" or "if only" with "Next time, I'll..." I have found this advice to be fantastic in principle, and I appreciate the forward focus on self-improvement as opposed to sulking over past mistakes. However, I personally have yet to be able to give myself permission to move past the self-imposed torture. Perhaps some balance between the two is best. I don't know the answer, but if you figure it out, please let me know.

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