It’s 1:15 am as I write this.
I’m tired. I’ve worked just under 17 hours today, but I can’t sleep.
Too bad. I will start at 8 am again tomorrow for another 8 to 9 hour day.
I can’t sleep because I’m thinking about my patient with the declining oxygen saturation. I worry that I may have missed something in the history, in the investigations… did the on call physician and I make the right decision?
I think about her. The quiet manner. Not wanting to be a bother, to make a fuss. I think about the family. Thank you, doctor. That’s what they had said.
They had trusted us. They had trusted me.
The popular Human’s of New York Facebook page posted a quote from a famous paediatric surgeon. He spoke of the handful of times a child had died on his operating table. He spoke of the profound sense of failure; of being suicidal and unable to sleep for days after each of these tragedies, sincerely wishing that he had died instead.
I’ve certainly never experienced such a traumatic event in my short career, but I can understand the emotions all the same. I didn't before becoming a doctor.
It’s moments like these that you don’t give a shit about your license, your name, your reputation.
It’s all about her. Is she going to be okay? Will she be there when I come in tomorrow morning?
These are the moments patients don’t see. They see us as the doctor, the larger-than-life superheroes with knowledge and expertise that save lives and work miracles. Maybe they need us to be.
They don’t see the stress. We have some of the highest rates of suicide and substance abuse; more than any other profession.
They don’t see the sacrifice. It's less than glamorous. The hours of training. The weekends and weeknights of our twenties, voluntarily offered for this career.
They don’t see the vulnerability. The loss and disappointment we too feel when patients don’t have the outcomes we had also hoped for. The nagging doubts, the moments of insecurity, the fear of failure; the sense of failure we all feel from time to time, but are afraid to confess…
The nights we go home and can’t sleep.
I went into medicine because I wanted to help people. It is the simplistic, cliché answer we are told never to give during our many rounds of interviews to reach our professional goals. The reason, of course, is because most of us did. We doctors, of all people, are the romantics, the endless optimists. We truly believe that knowledge, skill, dedication, and randomized control trials can heal the world.
Maybe we need the superhero paradigm too. Not because we want to be larger-than-life, but because we want to believe the world can be saved; because it is too painful to see the fallibility of not only ourselves, but of our profession as well.
So I write. I hesitate to share this. I fear it will hurt my career. Will my colleagues see my humanity as inferiority and weakness? Will the public, my potential future patients, interpret it as incompetence? Do we all just prefer the illusion of doctors as superhuman?
But my humble confession remains.
It’s not the first time this has happened, and it most certainly will not be the last.