Returning to the OR
Dr. Greene said that weekly morbidity and mortality conferences, which enable surgeons to come
together and discuss surgical outcomes, have been
helpful for him. Dr. Greene said the conferences,
which were started by Ernest Amory Codman,
MD, FACS, a founder of the College, are educational and provide a supportive atmosphere for
surgeons at all stages in their careers. Even after
analyzing outcomes, however, surgeons must
remember that negative patient outcomes are
still, unfortunately, a reality.
“Many people can’t cope with that,” he said. “I
have seen surgeons who become devastated, and
that’s why burnout occurs.”
For Dr. Dunn, it’s important to get in touch with
peers and not become psychologically isolated after
losing a patient. When that happens, he said, you tend
to lose perspective. “You’ve got to have a place to
put all the negative energy that can occur because of
losses. Share your thoughts with someone you trust,”
If another patient is waiting to be cared for, however, the doctors agreed that there is no time to express
their sadness. Dr. Walsh said that learning to silo her
emotions has been helpful to her after a patient dies,
particularly if she must tend to another patient right
away. “You have to put those emotions away in order
to go take care of the next person who needs your
help,” she said. To deal with those emotions outside
of the operating room, Dr. Walsh said she turns to
people she cares about who can provide the words
and guidance necessary to help ease the pain.
Dr. Santry said there have been times when she
has cried with the families of patients after a loss.
But surgeons need to have a laser-like focus, she
said. They have to be so fully engaged with the next
patient that they simply have to shut down lingering feelings, if only temporarily.
Tyler G. Hughes, MD, FACS, ACS Governor and
Chair, ACS Advisory Council for Rural Surgery, general surgeon, McPherson Hospital, KS, agreed that
sharing the experience with someone else is helpful.
For him, that means talking to another physician or
someone other than his wife or friends.
“You have to find some objective way to see if you
contributed, and be honest with yourself about it,”
Dr. Hughes said. He added that it can be difficult to
do that in McPherson, where the population is 13,000,
and many people know each other.
Dr. Hughes cautioned against returning to surgery
too quickly after a loss. The event might cloud your
judgment, he said, and you don’t realize that you’re
not listening to your current patient because your head
is still back in the operating room with the last one.
Surgeons of his generation were trained to be “
bulletproof,” he said, but he’s learned that it’s not a sign
of weakness to ask for help. It can also be comforting to know that every surgeon has most likely gone
through the same thing.
“Never be too proud of your work,” Dr. Hughes
said. “The easiest case can go south, and [you should]
expect it to do so, because that’s going to happen one
day. Know that every surgeon has been right there.”
No matter the circumstances that lead to the death
of a patient, the surgeons agreed it’s always difficult
for all involved. Some surgeons said it was important
to keep in contact with the patient’s family because
interaction with the family helped to show how much
these physicians cared about the patient, while another
surgeon found the reassurance she needed to continue practicing surgery from these personal exchanges.
Many surgeons said it was important to talk to someone they trust after a loss, whether it be a family member or fellow physicians who help them see these situations objectively. No matter how sad they may feel,
however, it’s essential for surgeons to be able to put
their full focus on the next patient. ♦