The balance between medical failures and successes can be challenging to navigate. Yet, for our own benefit and sanity, we must accept our humanity.
When I see a patient with a medical issue that I am not completely sure about, I will often have my nurse call the patient two or three days following the appointment to see how they are feeling or if the treatment I prescribed was helpful. This morning I received a message back from one such phone call in which the patient reported (in her words) a miraculous recovery from her joint pain. It is easy to pat myself on the back and feel great about the superb diagnostic skills and treatment plan that led to this great result. However, I, unfortunately, also deal with the failure of my diagnostic skills or treatment plans more often than I would like.
In our ongoing discussion about balance, I propose that balance must also be sought and found between the two extremes that can plague any physician - a God complex and feeling completely responsible for every bad thing that happens to your patient. While at one extreme, the doctor congratulates herself for her brilliance and skill, and on the other end of the spectrum, berates herself for not being perfect, these are two sides of the same coin. It is the mistaken belief that we as physicians are in control.
Now, we do have a lot of control over our patients' lives. We can effect both great harm and great benefit. We often are the voice our patients listen to above all others (with the exception of Dr. Oz, of course). We make decisions and judgments quickly. In fact, if you think back to the last 24 hours and all of the important, potentially life-changing decisions you made for and about patients, it can feel a little overwhelming. All of this considered, we still lack control.
We cannot control the cruel hand of fate. We do not control the choices our patients make. We fail time and again to control our own humanity - the humanity that makes us tired, or overwhelmed, or wrong. We do not have complete control over the way a medication works, how a surgery will help a patient (or not), or whether a diagnosis is terminal. Yet, we, probably more than our patients, our staff, and society, often hold ourselves accountable for many things, both big and little.
Instead of control, we must seek influence. Recognizing that while both miracles and catastrophes happen with seeming disregard for what we want or someone's age or goodness, we nevertheless are appointed by our society to be the intermediary between our patients and their lives and deaths. This is a heavy burden, one for which we are solemnly trained. However, we need to recognize our role and acknowledge it for the privilege it brings as well as recognize its limitations.
The balance between our failures and successes can be challenging to navigate. It is easy to feel to greatly either extreme. Yet, for our own benefit and sanity and wellbeing, we must accept what our patients already do - we are all simply human.