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May. 2nd, 2013 12:29 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
estelracaSo 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.
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.
no subject
Date: 2013-05-03 06:07 am (UTC)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*
no subject
Date: 2013-05-03 05:14 pm (UTC)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.
no subject
Date: 2013-05-03 05:22 pm (UTC)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!