estelraca | (no subject)

So I've hit that terrible milestone--my first mistake that ended up in a patient's death.

A cat came in for a spay. It was a stray, pregnant, just adopted by a really nice family. I did the surgery, because I love surgery. It's one of the things I usually feel most confident about. Whenever you do abdominal surgery, there's layers of the abdomen to close, the most important being the linea alba. It's the part that holds all the intestines and everything where they're supposed to be. They pound into us again and again in vet school to make sure to close the linea properly. Towards the end of the surgery one of my long-running patients came in, so I was hurrying to finish things. I remember hurrying. I think I checked the linea. I usually do. But I don't remember.

The cat came in the day after with an incisional hernia. It wasn't severe, just some omentum (basically special abdominal fat), but it means I fucked up the linea closure. I didn't put the stitches close enough together or I missed one at the end or... I don't even know. But the only way this happens is if the surgeon made a mistake. It's something we have to put the animal back under anesthesia to fix.

One of the other doctors put her back under anesthesia, and she crashed. Dead for ten minutes. We got her back, but not fast enough. She spent two days in the hospital, with us trying everything we could to see if we could get some kind of functionality back, and she just kept lying on her side and staring at nothing. Or crying methodically, every thirty seconds. Both were pretty terrible. And then she went downhill even from there, and we euthanized this morning.

I just.. don't know how to handle this. They told us this would happen. Two of our professors, in two different graduation speeches, told us that we would make mistakes, and that at some point those mistakes would result in a patient's death. And I, like the stupid little proud thing I am, thought, "I won't let it happen to me". But it did. I screwed up, and a gorgeous cat died because of it. I'm afraid to do surgery. I just want to curl up somewhere and hide. And the usual things I do to help with work-related stress aren't really helping. I tell people about it and their first response is "it's not your fault". Which, no, the anesthetic death wasn't my fault. I wasn't involved in that part at all, and it's something awful that happens randomly. But I'm the reason it had to happen, because I screwed up the surgery. If the cat had come from another vet, and I'd seen the incision like that, I would blame the other vet. Not to the client's face, because professionalism and who knows what else was going on, but I'd think that the vet screwed up closing the incision. But how do you deal with that? Always, in fiction (published or fanfic, because reading about Combeferre or Joly or McCoy dealing with Doctor Things is another one of my coping mechanisms, sometimes), when doctors are having a hard time dealing with something, someone else tells them "oh, it wasn't your fault" and somehow absolves them of their guilt. But I am guilty.
I don't know. I'm just rambling now. I'm tired from two weekends in a row on. Cat's going to be gone this weekend. And I just want the whole world to disappear for a while, except not, because then all I hear is the kitty crying.

Flat | Top-Level Comments Only

From:

enjolras

Yeah, you fucked up. It was your fault that the cat ended up dying. You messed up severely because you were hurrying. Something else may have taken precedence. And yes, a cat is now dead thanks to you.

And nothing you say or do will bring that cat back to life. You can't reverse that mistake.

However, in the end, it's not the mistakes that show us who we are, it's the aftermath. It's what we do later, after the self-beration, after the realization that we screwed up. That, as a doctor or surgeon, you hold life in your hands.

It is that fear of making another mistake that keeps doctors from feeling like god. It's the sensitivity people have after losing a patient that keeps them human, that means that the job hasn't gotten to them.

It's your right to be afraid of surgery. But it's your responsibility within your career path to acknowledge you fucked up, but also how to get past that and learn from it. Keep the error in mind, and use it to improve. Blame yourself, but don't become so immersed within your guilt that you forget that there are other animals out there that you CAN help, that you CAN keep alive.

By holding onto this death and not performing surgery again because of it, it's effectively killing more than one cat. You have talent. You have abilities.

And if we're going to be taking the high ground here, you owe it to that cat to learn from your error and never repeat it again. So instead of just working for yourself and Cat, you're also now working for that deceased cat. Honor the cat's death by doing what you do. If you just let the death hinder you to the point of not doing something you're good at, something that will aid others, then it's effectively dismissing that life.

From:

estelraca

Ah, Vee, you're very good at telling me exactly what I need to hear, even if it hurts. I didn't think I had any tears left after I posted this at lunch. I was wrong.

It's weird. Everyone else keeps trying to tell me that I didn't do anything wrong, and my reaction is to want to scream "but I did". (Except my boss, but he's busy feeling guilty because the cat died when he was putting it under. Yay, guilt party for all.) Having someone finally say "yep, you fucked up" makes my brain go "but maybe something else happened!". And I'll never know, because I can't remember the end of the surgery. Probably I made a mistake; much less likely something happened with the suture or the cat picking at the incision; either way, my surgery went south and the kitty had to pay the price.

I actually had to go and do surgery on a five-week-old kitten immediately after lunch, and it went fine. I'll get back on that horse--I do love surgery, and it's something I'm good at, something I got an award for at graduation.

I want to be superhuman. I want to be perfect and have all the answers and solve all the problems and save all the animals and remember everything and catch all the little things that owners say at the most ridiculous times and not have to worry about money or compliance or timing or things going wrong. But I can't be Superman. I can just be the best human that I can be, and try to make that good enough.

And be really grateful that people don't hate me when I do make mistakes, even when the result is terrible.

From:

enjolras

I doubt I told you anything that you wanted to hear, but I have mad issues with being comforting.

Your boss, I'm sure, is trying to make it easier on you. Considering how hard you're taking this, your boss' actions are fully understandable. I'm sure they want you to bounce back from this, but it's not always that easy. And it shouldn't ever be easy to just bounce back. You should feel what you're feeling. Aside from letting it guide you and learn from it, it also keeps your humanity in check. It's good that you're taking it hard. That, of course, doesn't make the feelings hurt any less, nor will it bring any comfort, but you're not looking for comfort now, I'm betting. Any given would seem almost...I dunno. False in a way.

You are, however, very strong. You need to be for this line of work. I would love to work with animals and save 'em and all that, but I know I'd lose it bad if any ever died. I can't put myself out there like that. But you can, and you're needed to make up for the wusses of the world like myself.

And you're right in knowing that you're not Superman and all that. I think, deep down, we all have a savior complex of sorts. Sometimes it's predominant, and we take a failure harshly. Sometimes it's mild, and we can move on fairly quickly. But the lesson of 'you can't save everyone' is always hard to learn. It's never learned easily. Because while others can tell you this, everyone refuses to believe it until they experience it for themselves. The lucky ones escape with minimal scarring.

In a way, though, it's also a passage for you. You have made your first real life-or-death mistake. It's, in a way, akin to a child becoming aware of their own mortality. A step up both mentally and emotionally. You're wiser for it, though the lesson hurts like hell.

I'm glad you're continuing with surgery. I'm glad you're willing to get back on that horse.

On a sidenote, it's my headcanon that Joly is way above par when it comes to surgery. He stutters a little and twitches nervously when having to tell someone their diagnosis, at least when it pertains to a STD, but surgery is where his talents really reside. Partially because he's normally put in warzones - barricades, etc - where surgery comes as a necessity rather than saying "Got some bad news for you. Your leg's gonna have to be amputated, and it looks like your colon had a bright idea when you shoved that lightbulb up your rear, but here's the real bad news. Everyone here who hasn't got syphilis, raise your hand. Ooh, not so fast there."

From:

estelraca

My boss has been pretty much the greatest throughout the whole debacle. We sat down and went over what happened and all the possibilities, and then today he did anesthesia and had me do the spay for a pregnant cat and everything went the way it should. So, both back on the horse together.

I can totally see Joly as a surgeon. Those of us who suffer from Med Student Syndrome, believing we have every disease we see and learn about, tend to be detail-oriented, which also works really well in surgery. Poor Joly. Trying to tell someone they have syphilis would be so incredibly awkward--bonus awkward points if it's a friend. People are so weird about anything involving genitalia anyway--especially men with female dogs, it seems. The married ones with kids who can't manage to spit out the word "vulva" no matter how many times I prompt it to them but rather have to go "privates" or "bits" or "down there" (which isn't even an accurate euphemism in dogs since it's more "back there") are the ones that always make me want to head-desk.

From:

mmejavert

I can only imagine how horrible it must feel. I never know what to say: my aunt is a hospital pharmacist and one day missed a doctor's mistake on an order -- a decimal point in the wrong place -- which accidentally overdosed a patient to death. She was upset and unable to sleep for days and somehow there was just nothing anyone could say (including me) to make her feel better about it, even though it was the doctor who'd made the original mistake in ordering the wrong dose. And yeah, these things happen, but that certainly doesn't make them any easier to bear.

*hugs*

From:

estelraca

*hugs back*

I'm not sure there's anything right to say in these situations. It does help having the story out there, though, and just... not having people hate me for it? If that makes any sense. I'm so sorry your aunt had to go through that, too.

It's so damn easy to make mistakes. And then trying to find a way to live with the consequences.

From:

bobbiewickham

I'm so sorry, for the cat and for you. I've no words of wisdom, just sympathy and respect. You may have made a mistake, and the consequences may have been awful, but that's what inevitably happens when you're a human being doing an important job. It doesn't invalidate your ability to do the job.

From:

estelraca

Thank you. I think you found pretty much the perfect words of wisdom. Just... thank you.

From:

box_of_doom

Many careers are held to higher standards in different areas. Teachers, for example, have a code of conduct that pretty much involves insisting that they keep to a fairly straight and narrow life in order to be considered presentable and trustworthy by parents to care for their children. I'm pretty sure I've heard of teachers being fired for posing for nude photos before, for example.

In the medical world, I suppose that equates to the inability to make mistakes. While it's not good for people to make mistake in any field, for most of us an error in judgement is more likely to result in some lost time or income, rather than killing, or deeply effecting the quality of living of someone's life.

Still, your'e human, and as a human mistakes do happen. It may be possible that the cat's owners will never come to see you again, because you as a unit killed their cat. You may have fear and trauma stemming from the experience. But most of us will still stand behind you and beside you, because you do a heck of a lot more good than harm, and as your professors said, mistakes do happen, and this is a part of the professional life.

I'm glad to hear that you had another surgery today, and that it went positively. I'm glad that there is at least some moving on that you can do and that you are doing. I'm sorry that you're tired and that Cat won't be around, and I hope that you can relax despite that. At the very least, you should go pick up some free comics and enjoy doing a bit of geeking out.

I've got a feeling that a lot of us still think you're awesome, even if you do mess up now and again. You're a lot more than your mistakes after all.

*hugs*

From:

estelraca

The owner's actually taking it a lot better than I am, I think. The woman's a friend of one of my bosses, and really aware of anesthetic risks, and is pretty much just blaming it on bad luck.

When two professors think it's important to tell us to prepare to make mistakes and prepare to live with the consequences, I should probably believe them. But the only thing I can do is try really, really hard not to make any mistakes, which is already what I'm doing.

Thank you. I know this couldn't have been an easy thing to read (...why do I not have more cute/funny work stories that I remember to post). It means a lot to be so brutally honest and have people still say that it's... okay isn't right, because it's not okay, but that I don't deserve to be drawn and quartered? Because that's kind of how I felt, and yet everyone kept trying to tell me that it wasn't my fault when it very well could have been, and... yeah. Was not in a good headspace. Doing better now, and I'm going to do everything I possibly can to keep this from ever happening again.

I forgot that it's free comics day this weekend! This is a very important event.

From:

box_of_doom

That's good then. :) I know enough people who wouldn't have taken it that well.

Well, to use Ms Frizzle logic, life is about taking chances, making mistakes, and getting messy. It's what you get from the mistakes that's important in the life's journey, not that you made them. Trying very hard not to make the same mistake twice is a good part of that, and it's wonderful that you're doing that, isn't it?

It's also May the Fourth (be with you). A geeky [and therefore important] day indeed!