"Brave Enough Through Malpractice Litigation" By Dr. Stacia Dearmin
Brave Enough through Malpractice Litigation
Malpractice litigation can be one of the hardest things most physicians ever face. My own patient’s unexpected outcome and the subsequent malpractice lawsuit challenged me to the core both as a physician and as a human being like nothing ever had before. As many physicians do, I felt deeply isolated, and struggled mightily to come through the experience with my heart, my mind, and my love for life and my work intact. My passion now revolves around blogging ( CLICK HERE ), speaking, and coaching colleagues through this complex aspect of our professional and personal lives,
When I first became acquainted with Dr. Sasha Shillcutt’s use of the image “Brave Enough” to describe her life in the world of medicine, I immediately thought of this slice of my own life experience. Fundamentally, we physicians are deeply courageous human beings. After all, even the first year of medical school takes us places where most people would never choose to go. My patient’s unexpected death and malpractice litigation stretched my bravery, though, in ways too numerous to count. I want to share three of them here today. Truly, being brave enough brought me out on the other side, and for that, I am grateful.
Brave Enough to Feel All My Emotions
As I’ve often mentioned on my own blog ( CLICK HERE ), a patient’s unexpected adverse outcome chased by malpractice litigation creates a swirling mess of confused emotion. Like others, I experienced a constantly shifting mix of physiologic distress, grief for my patient and her family’s loss as well as my loss of sense of self, shame over not having been able to prevent it, and guilt over any part that I might have played -- even if I could not tell you exactly what that might have been. Unaddressed, that mix of emotions can be overwhelming.
I survived in part by falling back on the advice of an old friend. Were he still alive, this man would be 100-years-old at least, and what a blessing his memory is! Big Bob -- BB for short -- was this big-hearted, colorful guy who lived generously and carried a boat-load of the variety of wisdom one earns only through direct life experience.
“If you feel, you heal!” he loved to say. Having printed it on business cards, he handed that motto out to friends and strangers alike. For years in fact, it hung on my fridge. Having met him in his strikingly youthful late seventies, I was always aware that I wanted to age like BB. He swore that those words -- “If you feel, you heal!” -- were the key.
When my crisis emerged, BB was in his nineties. His motto became my mantra and served me well. When my pain and sadness were most excruciating, I made a conscious effort not to sweep the emotions under the rug. We doctors develop real skill at that, but trust me, these emotions refuse to stay confined. So, I said to myself repeatedly, “Stacia, if you feel, you heal.” BB’s happiness signalled that I could be okay. And he was right. Allowing feeling brought healing.
Brave Enough to Face Fear
Extensive literature (CLICK HERE) on the experiences of physicians confronted with painful, unforeseen patient outcomes tells us what some of us know firsthand. Fear surfaces after that bad outcome in a big way.
You may fear that you personally caused a bad outcome single-handedly, fear that you’ve chosen the wrong profession, fear that you will lose your colleagues’ respect, your license, or your livelihood, fear that you will never recover to practice with confidence again. And fear in the midst of malpractice litigation? Let’s not even get started on that one.
For me, another mantra was essential.
It was, “Walk towards your fear.” One baby step at a time, I walked towards my fear. Dealing with deposition? I walked toward the fear. Nervous around recredentialing time? I walked toward the fear. Approaching the courtroom? I walked toward the fear.
I can’t recommend this mindset highly enough. Fear inspires in us a desire to turn and run. While there are some situations in life where that makes sense, in this instance it doesn’t work.
This fear is a dense fog. From a distance, you can’t see through it. Even up close, you may not be able to see through it. But if you rely upon good legal counsel and remain connected to at least one person who respects you and has some sense for what you’re going through, and keep taking those baby steps toward the fear, the fog will fade to mist and you’ll get through it. You may always look back on this time as fearsome, but you will come out, and on the other side, marvel at your own strength. You can rejoice that once your bravery grows, it doesn’t shrink back.
Brave Enough to Welcome the Mystery
My parents are deeply religious people. While they and I express our spiritual impulses differently, we are all people with a strong sense of living our lives surrounded by a great, sustaining Mystery.
I know many wonderful people who do not share this lived sense. To them -- and perhaps you -- I would say that no, I do not doubt that they -- or you -- are as right as I am. After all, I wouldn’t call it a Mystery if I understood it, now, would I? I simply think that this tendency may be inherent to my parents’ nature, as to mine.
For me, the unexpected death of my patient represented a pivotal moment, one in which I felt that I had failed Life. Or Life had failed me. Or both. In any case, I struggled for quite some time with feeling cut off from my Source. For several years, I felt alone in a deeper way than ever before.
In the years leading from the original incident to the time of my trial, I spoke very little about the matter with my parents, ordinarily cherished confidants. I had been advised to “speak to no one about the case,” and wasn’t clear about just what that meant. In any case, I didn’t want my parents subpoenaed. Furthermore, I hated for my anxiety to become contagious. So, they knew that I was hurting, and I shared that a lawsuit was filed, but otherwise I said not much.
As trial approached, I absolutely had to seek their support. I hurt so much and felt so strained that I simply could not go to trial without them behind me, even from many miles away. In a conversation just a few days before trial, I let them know that it was right upon me, and I asked them to keep me in their prayers in the coming days.
In response, my mother gave me touching advice which proved prescient. “Stacia,” she said, “I want you to remember that God will be in the courtroom. No matter how this goes, you do not go in there alone. If you watch carefully, you will see little glimmers here and there. Please promise that you will look for them.
I know that to some of you, that must sound like the strangest advice ever. Doo-doo-doo-doo, doo-doo-doo-doo “Twilight Zone”-level weird, maybe. That’s not the effect I intend to create, so let me translate her words for you.
Mom was trying to tell me that Life lives itself through everyone who was going to be in the courtroom just as it lives itself through me. She was reminding me of the potential for serendipity and synchronicity in the most unexpected times and places. She was asking me not to allow fear to close my heart to possibility, directing me to take openness with me as I went into a very scary place. Just as patients who go into major surgery with a positive mindset heal better, my mother was encouraging me to go into trial with a mind open to the potential for goodness to come of it.
And she was right. Much of the time spent at trial was very, very hard. Nonetheless, there were these moments where my jaw nearly dropped in response to something said by a potential juror, a witness, or a lawyer -- something which spoke to me deeply and allowed me to continue to heal. These little glimmers were like tiny candles in darkness. As my dad often says, once even one candle is lit, darkness is no longer darkness.
Those glimmer-moments are what I would call grace. They were a gift to me just like glimmer-moments are often a gift to our patients in their darkest hours. Without my mother’s reminder to allow for them, I don’t know whether I would have even seen them, though. Setting down the heavy armor I was wearing at that moment took honest bravery.
I want you to know that you, too, are brave enough.
Dr. Stacia Dearmin is the dedicated founder and owner of Thrive: Insight, Education, Support devoted to educating and supporting the physician community around the challenges of unexpected outcomes and medical malpractice litigation. Contact her via her website, www.thrivephysician.com, or follow her on Twitter and FB @thrivephysician.
A mother, gardener, obsessed knitter, and occasional runner, she also practices and teaches pediatric emergency medicine in Ohio.