Friday, March 21, 2008
A Horrible Feeling
Probably I shouldn't write when I feel this way. I'm stunned by the death of a really good person, whom I've known for a long time. Our kids were friends. We spent lots of time on lots of sidelines of lots of athletic fields, watching our kids and talking about whatever parents talk about. Let's call her Mary. And the thing is, she died after an operation of a sort that I did all the time and which, had I still been in practice, I likely would have done for her. Which is, among other things, why I feel so bad.
I've always felt guilty about bailing out a few years younger than I'd intended. I tell myself -- because it's true -- that in my foreshortened practice I did more surgery by far, and saw more patients by the thousands, than most surgeons do in many more years. That's, of course, one of the reasons I burned out. But the guilt has until now been sort of generic. Today, in a bizarre and (I know) entirely unrealistic way, my guilt is personal. I feel like I let Mary down by not being there.
There's no reason for me to think mistakes were made; in fact, they most probably weren't. But I find it nearly impossible not to think that had I done the operation, and had I done it the way I always did, Mary would have done fine. I never had such a thing happen to my patients, and I've done many more than the surgeon who did hers. Of course, bad outcomes can happen no matter what; and had it ocurred if I operated, I'd be feeling immeasurably worse.
One of the corollaries to being able to dramatic good as a surgeon is the potential to do devastating harm. I've had operations turn out badly even when done well. It's an awful thing. But this is the first time I've felt like this: a sick feeling at the loss of a friend, compounded by a hard-to-suppress sense that had I had the (what is the word? Character?) to stay in practice longer, it wouldn't have happened. I wish I'd been there. Perhaps it's not so much guilt as helplessness in the face of tragedy.
The tragedy is not mine. It's Mary's wonderful family's. But as her husband told me the sad saga, in my mind I was shaking my head and screaming in exasperation. Maybe it's just an example of a false sense of indispensability in the way I used to believe it. But, for whatever reasons good or bad, I feel deeply sorry right now, for Mary and her family, and in some perverse way, for myself. It's painful and embarrassing to admit it.