The Human Condition VS. The Human Physician

As a modern medical student I am fortunate to attend a medical school that has required curriculum in medical ethics. Normally in this class we discuss the ethics of issues like medical justice, rationing of limited supplies (i.e. donated organs), spirituality in medicine, etc. Today however, we strayed a bit onto the personal side, the human side of the physician, talking openly about the skeleton in each physician's closet...

Medical mistakes have historically been something physicians do not discuss for several reasons. First, admitting a mistake means admitting fallibility in a profession that commands perfection from all angles. Second, fallibility is not too far from loss of self-confidence and loss of peer respect. Third, our society is vehemently litigious.

Most physicians make very few mistakes in any given time period and only a small percentage of those mistakes do harm to a patient. However, even a harmless mistake, once realized by the physician creates deep feelings of anxiety, self-directed anger, fear, and oftentimes depression. These more severe responses are certainly heightened as the magnitude of harm done to the patient increases. But, for the 3 reasons listed above, and many more unmentioned, the physician is not allowed to deal with those emotional and spiritual issues in a psychologically healthy way. Many spend the better part of their career carrying this baggage until they learn to deal with it effectively or unfortunately turn to alcoholism, drug abuse, divorce, and suicide.

How we deal with this problem is a topic for a different discussion. My point today is the significance that this was discussed at length by 200+ future physicians in small groups today at Des Moines University. This is a historic paradigm shift for this profession! Today students were given the opportunity to understand that we will eventually make dire mistakes despite all the best intentions and training we'll have. We learned that we need to prepare for this by having support systems in place so that these events can be properly processed, grieved, and learned from. This is a great time in medicine now that physician's are beginning to care for their own physical, spiritual, and mental health. Hopefully more take action in these areas.