It can be a roller coaster, folks. This life of putting your hands, needles, and scalpels on people. A week in the life of a superheroine can be trying.
One week I am lauded for saving a life, and the next week, I can deeply disappoint patients and colleagues. That’s the way it is.
I just need a mantra at these moments: “I can’t destroy my reputation with one procedure.”
That’s my hope, at least.
No pressure, right?
Of course, there is pressure. It’s peoples’ lives and limbs at stake here.
So I messed up at work. Like I really made a really stupid, thoughtless mistake. I haven’t made this exact error ever before, and I haven’t made a comparable error in years. But when you do a thousand procedures, you might make a dumb mistake in there somewhere. It sucks, but it’s true.
This error is something I did, and I did it alone. I confirmed the plan with the nurse in the room, and then 5 minutes later proceeded to do the procedure on the wrong side, and my assistant let me. It’s not his fault, he lacks experience, and probably couldn’t even see where I entered the skin, with the fluoroscope blocking his view.
I didn’t recognize my error until hours later, as I went to dictate the case. Right. I worked on the right side. The pain was on the left. My face flushed, and my head slumped into my hands. Fuck fuck fuck fuck fuck. No no no no no. Not on this patient. She had already been through enough. Why would I do this, when I should have been paying attention? Everyone matters and is theoretically equal, but if anything, I should have been hypervigilant in this case. This patient trusted me implicitly, and I let her down.
I felt nearly incapacitated with shame for the rest of the day. I notified the department manager, who entered an incident report. Will they take my license over this? I don’t think so…
As often comforts me in these cases where the outcome is short of what I’d hoped, I tell myself, if no one died it’s going to be okay. The thing is, I told the patient there were serious risks, and then I proceeded to work on the wrong side as if I didn’t take it seriously enough. I stated the gravity of the rare (but real) risk and then disregarded it with my actions.
I spent the afternoon trying not to hate myself for making a mistake. Trying not to blame anyone else, because that’s my go-to move when I feel vulnerable or hurt, is to blame. It is certainly not a tendency I’m proud of, and it’s one I’m actively working on. Blaming fills some kind of need in the moment, in a maladaptive way.
I felt horrible making a mistake. Later that night, I was called in emergently to care for someone who was bleeding to death. I selected the bleeding vessel instantly as if driven by some sort of dumb luck. Incredible fortune, I thought. I was lauded by the vascular surgeon who came in for an update, just as I’d finished. I did my show-and-tell, pointing to my angio and embolization on the screen, as he admired my work.
“Great job,” he boomed. “You saved a life!”
I muttered, “After the day I’ve had, I guess I had an easy select coming to me…”
My new colleague and I exchanged phone numbers and parted ways. The patient was coming off blood pressure support. A victory, but in the shadow of my mistake.
The next day, the victim of my error returned for her procedure: for another chance to get it right. She was gracious and listened to my apology. The case went well. I think it will help her.
I returned to the ICU and the person I ‘saved’ the previous night is now on four vasopressors. She stopped bleeding but her heart couldn’t take the insult. Does this feel like whack-a-mole to anyone else?
And riding the emotions of a week in the life of a superheroine can feel like being on a roller coaster. I’m not going to lie. In one way you’re up, in another way you’re down. It balances… sort of. If you’re a good doctor, you care… and people are sick. Outcomes can be good, bad, and everything in between.
And this is to say nothing of those who greet you at home, from your fur babies to your partners and children. They add other (mostly) wonderful variables to your life: they can make the roller coaster ride sharply turn left or right, as it coasts wildly up and down.
Back at work, you can be a savior, a dunce, and everything in between. But this is the life we chose- a life of one challenge after the next.
“Why not?” we probably thought at some point. We are talented and bright, and we can do so much good. It’s just that in these moments– and in these tough weeks– the challenges overwhelm. The shame stings. We try to help people as doctors, and we’re not perfect, no matter how hard we try, or how much we wish we were.
I’m just being transparent. This is not a boring, stable life. Not for me, not this week. This is a week in the life of a superheroine.
If you are feeling some similar way, I’m sending my solidarity and hugs to you, superheroine.
The path can be riddled with failures, even if you're doing it right. In this recording, I share some of my gaffes with you.