Hero doctors

In our weekly anesthesiology morbidity-and-mortality meetings, we swapped tales of derring-do. How, in the face of overwhelming illness or major injury, we somehow saved lives. We conspired to reassure ourselves that poor outcomes were not our fault.

While the details of technical care were turned over and dissected, the subject of our emotions, feelings, fears and vulnerabilities were off the table altogether. These are taboo subjects in the hospital medical culture.

I worked at my last hospital for eleven years. In that time, only once did I hear a senior doctor speak of personal vulnerability, openly, in front of others. He was an obstetrician and gynecologist who confessed to me in the operating room, in front of the nurses, that he hadn’t felt like coming to work that day.

The day before, a cesarean section had gone horribly wrong and the patient nearly bled to death. The surgical team fought for six hours to save her life, replacing her complete blood volume over and over. Eventually she stabilized enough to get her to the intensive care unit. This surgeon told me he was so traumatized by the events, he had just wanted to stay at home today, not operate on a list of gynecology cases.

In the last decade, that is the only time I have heard such a public confession of vulnerability from a senior hospital doctor.

Yet our failings and mistakes injure and kill patients every day. The accepted figure for the proportion of hospitalized patients, who are accidentally harmed in the course of healthcare, varies between 10% and 40% of all patients. Medical error is a leading cause of death.

This internal tension between our heroic, fearless ideal of doctoring, and the reality of so many patients that we cannot save, or we accidentally harm, is a source of tremendous emotional vulnerability.

But when we learn to bring open-hearted compassion to the care of our patients, we learn there is so much we can give beyond technical expertise and heroic doctoring.

It gives meaning and purpose to our work, even when our technical medicine toolkit is empty. With that deeper connection, we also begin to be kinder and more compassionate to ourselves. No need to be a hero.