Narrative Medicine Monday: My Human Doctor

Dr. Sara Manning Peskin writes in the New York Times about the fallibility of physicians and its emotional toll in “My Human Doctor.” Peskin introduces us to her patient, Shirley, who was given a diagnosis of multiple sclerosis. This patient finds that in assuming this chronic, often debilitating, disease, even the very word itself “crippled her. She’d stopped driving, stopped working, and adjusted to the stigma of having a chronic disease.” After a hospitalization due to a serious reaction to one of her medications, it was discovered that “Shirley might not have had multiple sclerosis at all.”

Peskin reflects that in medical training we do discuss errors but “[w]e don’t talk about the emotional trauma of hurting a patient. Instead, most physicians cope with guilt, self-doubt and fear of litigation in private. After our patients, we become ‘second victims’ of our mistakes.” Given the recent spotlight on depression and burnout in medicine, Peskin highlights an important point that we ignore to our peril. Some organizations are realizing this and offering more programs such as Balint, peer support groups, and expanded counseling services to explore and address this emotional trauma.

When Peskin suffers the consequences of a mistake made by her own physician, the response she receives is “‘I can’t turn back time.'” Peskin experiences first hand that “[a]pologies are difficult for doctors, not only because we have to cope with hurting someone, but also because we are scared of the legal implications of admitting culpability.” Peskin outlines how the U.S. system differs from many other countries, where the “‘no-fault’ system is based on injury from medical care and not on proof of physician negligence…” and “doctors and patients remain on the same side, and more patients get paid.”

Peskin does end up apologizing to her patient, Shirley, for the misdiagnosis of multiple sclerosis. They were then able to move forward in the doctor-patient relationship and discuss Shirley’s adjustment to the “possibility of not having a chronic disease.”

Writing Prompt: Think of a time your doctor made a mistake. How did they approach the error? Did they apologize? If you’re a physician, think of a mistake that you or a colleague made that is particularly memorable. What happened and how did you respond? How did the situation affect the patient-physician relationship? Consider writing about this experience from both the patient and the medical provider’s perspective. Write for 10 minutes.

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