Terrible things happen every day in Emergency Departments across the country and around the world. In addition to the patient victims, physicians and team members can be profoundly affected by these events. We are the second victims. I share here a story from early on in my attending career when I had a day that started very similarly to many others only to take a traumatic turn that has continued to shape who I am as a person and as a physician.
I was running a code which is a short, clean name for the all-out battle between life and death. It does little to convey the blood, sweat and tears of our team members trying to save your loved one. This code was different though, something I realized only well into the fight. Because, although I’d never spoken to this man, I became responsible for him approximately 15 minutes before he attempted to hang himself in our emergency department.
I still had to run the code so I attempted to stuff that realization down and press forward. We won the battle—our patient had a pulse back. However, it was clear he would not ultimately survive his injuries. And then I did what all of my emergency medicine colleagues and I always do following traumatic situations—I went back to see all of the patients who had built up in the Emergency Department while I was in this one individual’s room, only a few of whom fully appreciate the difference between their emergency and THAT kind of emergency.
I went home from my shift and put on a smile for my own family. While going about my life, I heard in my head, over and over, the sign-out information, the code situation, and the parent conversation. I was wide awake the next day when I had to go back to work. I know of colleagues who have worked fevering, vomiting, even laboring and so I did what all of us have been acculturated to do—I went back.
Following that shift, I knew I was in trouble. I could feel the tide rising and I knew if I didn’t talk to someone this unexpected event would overtake me. I talked to a counselor many times about this event and in addition I did some research. And what I found was a surprise. A significant number of sentinel events reported to the Joint Commission are triggered by a patient suicide and nobody says a damn word about it.
There are many other types of adverse events that affect us as physicians, including the death of a pediatric patient or of someone we know. We carry with us our personal graveyards of the patients who walked in and dropped dead right in front of us, the first patient we pronounced, the one who looked like so-and-so or had been in our emergency department 100 times previously. Cloaked in silence these events can drive physicians to quit or worse. But by sharing our collective stories, we have the power to change the trajectory of second victimhood and to ensure that we reach the other side not only surviving but thriving.
Watch the full FIX17 talk below!