Doubt

The email looked like spam. It was from a sender I didn’t recognize, and had a bunch of numbers in the subject line.

“The attorney at __ Hospital would like to speak with you regarding the above patient case.”

That’s all the email said. But it was enough to make me feel like I had been punched in the stomach. Which patient could they be talking about? How bad was it? What did I do?

The life of a medical resident is hard. There are the long hours, a poor diet, afflicted relationships, and of course constant sleep deprivation. When you sign up for it, you know more or less that this is what is involved. But no one tells you about the worst part – that you will be plagued with a constant, gnawing sense of self-doubt and concern that you will do something, or not do something you should have, that will be the cause of someone’s life ending.

In pediatrics, we don’t lose that many patients. In my hospital it was maybe 5 a year. I remember every patient whose life I worked to save and was not able to, and I have played over and over in my mind the sequence of events – the medications, drips, intubations – to see if I could have done something differently.

I remember many times, after a long night of call, when I would not be able to stop thinking about that patient who was really sick and wondering if I did the right things that night. Should I have adjusted the ventilator settings more aggressively? Did I miss any signs of a brewing infection?…I would second guess myself all the way home, and then some. And what was worse were those times when I knew my mind was not fully functioning, when I had become a little dulled – that’s when you really feel unsure of yourself. Fatigue often had me teetering on the edge of indifference. Had it ever made me cross the line?

Reluctantly, I called the attorney. The case is about a baby who suffered from complications during his delivery. The mother is suing all the doctors involved in that process, including the pediatricians who were called down to resuscitate the baby.

As the attorney told me the synopsis of the case, stumbling over the medical terms in the lawsuit claims, I knew I would never remember the patient. I had probably run down to resuscitate newborn babies in delivery rooms well over 50 times in my years of residency, not to mention that it has been almost three years since I finished residency altogether.  But, while I knew that it was not uncommon for doctors to be sued in cases of brain-damaged babies (Does your child have cerebral palsy? Could your doctor have caused it? Call us now to file your lawsuit!), I couldn’t help but feel guilty. Was I responsible?

In the end, it turns out that I wasn’t actually involved in this particular case. The event had taken place a month after I had finished my residency. The email was sent to me in error…

I have no doubt that sometime again in my career I will be involved in a lawsuit. And I hope I will be able to say I did all that was proper and necessary to care for my patients. But I also know that tonight at work, I’ll listen extra long to all my patient’s heartbeats and double-check every dose of medication I prescribe.

And leave nothing, I hope, open to self-doubt.