“Aayiram paerae konnaven arai vaidhiyan”
(One who has killed thousand people is but half a physician)
There’s a grain of truth in this pithy quote.
Every doctor in training is grimly aware of it.
In your chosen profession, mistakes can be costly.
Death is the common destination we all share.
It’s true that we often have such complex feelings and attitudes towards death.
For many interns, this year will be your first intimate contact with death.
It can be scary – if you let it.
A lot depends upon your previous experiences with such loss. It conditions the way you feel about people dying. And it influences how that affects you.
You and I will die, someday.
And your patients, too, will die.
At times, despite your best efforts. And rarely, because of them.
Look, no doctor likes losing a patient.
And yet, it happens.
You’ll make errors of commission – when you did what you shouldn’t have.
You’ll make mistakes of omission – when you didn’t do what you should.
It might end in death.
It’s easy to get trapped in a never-ending ‘blame game’ and hold yourself responsible – in a self-defeating way.
But if we’re being completely honest, there’s no way to be absolutely certain that what happened was a direct (or indirect) result of your actions, decisions or choices.
My first thyroidectomy patient died – on the night she had surgery. For the next 18 hours, I bitterly blamed myself… until the autopsy report showed a massive pulmonary embolism from DVT.
Not every death is followed by an autopsy. There’s no way to confirm every detail.
And so we can never know the extent of our own part in the outcome.
Or if things would have been different. Or whether the result could have changed.
Maybe it could… or maybe not.
That’s why it doesn’t help to keep beating yourself up.
Instead, learn from any mistakes. Decide to never repeat one. And move on, determined to be a better doctor.
In the immortal words of famed French surgeon Rene Leriche:
“Every surgeon carries within himself a small cemetery, where from time to time he goes to pray – a place of bitterness and regret, where he must look for an explanation for his failures.”
I have my own. So does every doctor.
You will have yours, too, in time.
Use it to learn lessons. To make promises. And to grow as a physician.
Respect death. Don’t fear it.
Fight death. Don’t hate it.
Come to terms with death and dying.
It’s difficult, but necessary.
Have you read Dr.Sivasubramanian’s books on the making of a surgeon yet?
Read the other ‘Desirable Traits for Interns‘ here.