The conversation that extended my career

medical mistakes and conversation

My heart is pounding. My stomach is in a knot. I can’t think straight.

I made a mistake.

The mistake itself doesn’t matter. It’s happened a number of times. An overlooked vital sign, a forgotten lab value, or that time in medical school that I used epinephrine in a digital block. (I feel less badly about that now.) The specifics don’t matter, because the outcome is always the same. I can’t concentrate. My chest feels tight. My bowels feel loose. I’m shaky. The last thing I want to do is see another patient. I feel like a failure.

To err may be human, but at work I am supposed to be super-human. I’m a physician. People are relying on me. I need to be perfect.

Luckily, my mistakes (that I know about) have mostly been minor. But they never seem minor to me. They knock me from my pedestal. They cost me sleep. They hurt.

For years, I toiled through these errors on my own. I would think about them. I would try to learn from them. Then I would think about them some more, usually at the cost of a good night’s sleep. But the one thing I would never do is talk about them with my colleagues. I didn’t want to lose their respect.

Tonight, I made another mistake. I misread a number on a chart. Ultimately, there was no real harm, but I still felt like a failure. My heart raced. My hand shook as I tried to chart. I couldn’t eat. I could feel the rise of adrenaline that was certain to cost me another night’s sleep.

Then I talked to a colleague. As the words left my body, so did the stress. My breathing slowed and the shaking stopped. I had gained perspective.

There is nothing I love more than discussing medicine with my colleagues. Chatting about interesting or difficult cases always leaves me excited to practice medicine. I have learnt something new from every conversation I have ever had with a colleague.

However, I have always been hesitant to discuss my mistakes. I like having the answers. I like being the calm, collected leader in the resuscitation room. I like that people can rely on me. The last thing I want is to be seen as a bumbling fool.

So, I would reflect on my own. I would read and I would struggle to improve, but always alone. I thought this would make me feel better; stronger; smarter. Really, I just felt alone; isolated; scared.

I am glad I opened up to my colleagues tonight. I know people often hear legal advice about who you should talk to after making a mistake. That isn’t what this is about. This is my experience of stress melting away because I opened myself up. This is about my colleague’s ear providing me with a good night’s sleep. This is a supportive colleague extending my career and beating back the dark spectre of burn out.

Emergency medicine is grueling. You can’t do it alone. You don’t want to do it alone. That is why I love my colleagues. I couldn’t do this without them.

Cite this article as: Justin Morgenstern, "The conversation that extended my career", First10EM blog, April 24, 2017. Available at: https://first10em.com/the-conversation/.

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