Instead of Denying Emotions, Physicians Can Learn from Them
Medical doctors need to be able to confront the fear and shame that come with medical errors, for their own sake and for the sake of their patients, says a physician and author.
Early in her career, Danielle Ofri, MD, declared an elderly patient stable and went home. The patient's altered mental status was not unusual for someone in his condition.
The next day, she learned that he had been bleeding into his brain, a problem that was later caught and addressed. If it hadn't been, the patient could have died.
The system worked. The error was caught. But it was little comfort to Ofri, who has practiced medicine at New York's Bellevue Hospital for more than 20 years.
"I was so horrified," she said at a talk at Harvard Medical School last week. "I was so ashamed, I didn't tell anyone."
She carried that shame around with her for 20 years, but was able to use it in her most recent book: What Doctors Feel: How Emotions Affect the Practice of Medicine.
Ofri's talk centered on one emotion, shame, which she said overwhelms many doctors and is a major reason many medical errors go unaddressed.
When errors are not acknowledged, even those without bad outcomes, no one learns from them, she said. And, there is little incentive for doctors to point out their shortfalls. "We want to look like we know what we are doing. When in doubt, pretend. That's what I learned in my internship. "
'Afraid of Screwing Up'
Ofri, who trained and works at Bellevue Hospital in New York City, is a prolific writer, a practicing physician and editor of the Bellevue Literary Review. Described as a "born storyteller" by the late physician and author Oliver Sacks, Ofri builds her books around narratives from her own life as a doctor in a busy public hospital.
She shares those stories in her talks as well, last week admitting to a roomful of doctors and medical students that she and other doctors must cope with another overwhelming emotions – fear. Ofri said that she "spent every waking moment terrified as a student. I was so afraid of screwing up. "
Fear, however, is not always a bad thing, she said.