VULNERABILITY AND RESILIENCY- A LESSON ON HUMANITY FROM TIM
LEEUWENBURG.
This may be
old to some, but I watched a heartfelt video from a presentation Tim
Leeuwenburg gave at a few months back on dealing with our vulnerabilities “ALL ALONE ON KANGAROO ISLAND” Vimeo.com/130819016.
Without giving the talk completely away he goes through his journey of anguish
and shame during a misdiagnosis, leading to a patient who went septic, and
subsequently became paralyzed, only to learn a nurse at the receiving facility
told the wife she should sue him. After a two-year ordeal (alcohol, suicidal
ideation…) he was able to reconcile with his patient and his wife. Later he
describes his ability to look differently at life leading to his ability to
maintain empathy and compassion at a different level. Sadly, he received the
typical support we all do when we endure a tragic situation resulting from our
own mistake.
I began to
recall the ACS papers a few years back on burnout in surgeons and the high
association with medical errors, subsequent distraction, more errors, abuse and
potentially suicide. About the same time the ASA published a paper in 2012
about how rare it is for an anesthesiologist to take the day off after having
just witnessed a tragedy in the OR. I recently conversed with a CRNA who
relived a story with me, whereby he watched an unfortunate mother die of
hemorrhage after a delivery complication, and simply had to move onto the next
case. My point is that, last year I chatted with a local Sherriff Deputy who
was a State Trooper and asked him how they handle this in the police service.
He relayed to me the story of how he was called at 2am on a 10 degree January
day to a scene where an intoxicated driver speeding the wrong way on the
interstate, slammed into a car with four college coeds. He said he had seen a
lot by that point in his career, but nothing prepared him for the scene he
walked into. A decade later he remembers vividly that when he arrived, the
steam was pouring off the bodies which were severed in two by the seatbelts. I
asked if he had to go back to work (like we do). I was surprised when he said
that a Police counselor responded to the scene to assess if they were fit for
duty. He was clearly not, so they found a replacement for him. On that note, I asked Dan Linskey (ex Police Chief
in Boston and incident commander during the marathon massacre) and he too said
their police force relied heavily on on-the-scene therapist to assure that
people were fit to go on or needed time to recover. So it seems that our first
responder services do a better job of tending to their professionals than we
do.
So back
to this video…Dr. Leeuwenburg explains how we are all vulnerable. We often are
afflicted by shame or guilt in our profession. These unfortunately unclothe our
vulnerability when we are exposed to medical error, administrative frustration
(and our less than admirable responses), own expectations, and work-life
imbalance. We quickly find a difference between our expectations and reality
and are disappointed. As physicians, we idealize perfection and are less than
satisfied by “good enough”. His lessons
in the end were to work towards resilience (and not alone but with others).
Accept we are not alone in this battle and have empathy towards others who may
be suffering (be kind). Be prepared to expose your own vulnerability to help
yourself and others. In the end, he displays his transition in dealing with
human suffering as he describes his care of a brave fire-fighter with lethal
injuries, providing a humane approach and a lasting conversation with the
fire-fighter’s wife.
I hope this video is
motivation to change how we deal with tragedy, mistakes and stress in medicine.
I really would like to chat with Dr. Leeuwenburg at some point on this.
KENNETH A. LIPSHY, MD, FACS
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