In two months I will be a doctor. That is both thrilling and terrifying. It is one of the greatest privileges I can imagine for a stranger to let me into their life and their body, lay bare their secret pains, and ask for help. Sometimes I will be able to help, sometimes not. And sometimes, despite my best efforts, I will do harm.
Right now, I am still a medical student, shielded from this harsh reality by layers of safeguards. Though I am encouraged to take “ownership” of my patients and come up with a diagnosis and a plan on my own, a supervising physician always oversees my work and is the one who actually writes the orders or prescriptions. When confronted with a question I can’t answer or a challenge beyond my skills, I can hide behind “I’m not a doctor yet.” That excuse won’t work much longer.
On May 10th, when I graduate from UNC School of Medicine and officially receive my MD, I won’t suddenly be smarter or more knowledgeable, but I will carry much more responsibility. I will still have supervision and people to call on for help, but there is no doubt that I will make mistakes. Some day, I may even be sued for one of these mistakes.
Malpractice suits are a hot button issue, blamed for increasing costs in health care as doctors practice “defensive medicine”. They can destroy careers and wreck families, and it is hard to see who is helped by most of theses suits. That was certainly true in “Love Alone”, which I had the pleasure of seeing with other medical students and faculty last week. The stress, and the memory of her mistake, haunted the doctor being sued and helped drive apart her marriage. The family suing suffered through the endless revisiting of the loss of their loved one. In the end, medical malpractice must be discouraged and mistakes addressed, but the system is far from perfect.
Throughout the play, I kept returning to the opening scene, in which the doctor informs the family that the patient has died. The doctor is awkward, uncertain and defensive, and she does not deliver the news well. This is the most important scene in the play, not just because it sets up the entire plot, but also because this imperfect interaction sets the stage for the lawsuit. Delivering bad news is not easily taught, but medical schools and residencies are starting to incorporate training in these conversations. As I left the theater, I couldn’t help thinking about how differently the play would have gone had the doctor delivered the news with more compassion and honesty. We study and practice to be the best clinicians we can be, but sometimes the most important thing we can do for our patients and their families is just talk to them.