Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Patients should never underestimate the self-flagellation of the physician

Janet Tamaren, MD
Physician
October 12, 2021
27 Shares
Share
Tweet
Share

Patients die. This is a tragic truism in the world of medicine. Usually, the patients who die are elderly. Patients die from diabetes and kidney disease, or from alcohol abuse and liver failure, or from heavy smoking and lung disease. Or patients die from cancer.

As a physician, I take these deaths in stride. I try to provide comfort care as they lay dying. Patients often pass into a dreamlike state, at the end. They are not fully conscious. I provide morphine for any pain, which may or may not hasten their entry into the final, dreamlike state.

However, it is the deaths of patients who are too young that tear me apart. Instead, it is the deaths of patients I thought I could save that keep me awake at night.

I talk about this to a friend who was a psychiatrist. I lose a patient, but I am not sure if I have made a mistake somehow. The psychiatrist, who is in his late 70s, reproaches me.

“Do you think you are such an excellent doctor that no patients of your will die?” he asks. “That you never make mistakes? And the rest of us, whose patients do die, who do make mistakes – are lesser doctors than you?”

I feel stunned. Isn’t he supposed to comfort me? Isn’t he supposed to tell me I had done the best I could? Instead, he chastises me for thinking I am better than other physicians. It takes me a few days to realize that what he says is helpful. He tells me I am a member of the brotherhood of physicians. Physicians are human and fallible. He too had lost patients and blamed himself. In fact, upon further reflection, I realize that psychiatrists are at the epicenter of risk. They see patients who are depressed and suicidal. Psychiatrists always take the risk that a patient will kill himself or herself. And some will, no matter how skilled the practitioner is.

Kill as Few Patients as Possible, a book written by an internist in Los Angeles, helps me cope with failures. The author, Oscar London, says that when (not if) a doctor makes a mistake that causes a patient harm or even death: the doctor should sit down at a desk, take out a Valium pill from the drawer, and call a lawyer. The very sensible matter-of-fact approach somehow comforts me. He also describes how “Dr. Death” sits quietly in the corner of each exam room, making notes on each patient, and adding a patient’s name to his List each time a doctor fails to order the appropriate test or defers on an X-ray.

For me, if I sense Dr. Death in the room, eager to claim a patient, I reach out for a higher power: I send them to see a specialist or to the ER.

Patients should never underestimate the self-flagellation of the physician. It is always in the background: “God-willing, do not let me lose this patient.” The heavy responsibility to mediate with Dr. Death is the hardest part of doctoring.

Addendum: I wrote this before COVID-19 shut down the country. I have not taken care of patients during the COVID-19 pandemic. I can only imagine how stressful it must be. Dr. Death has claimed so many people in the past 18 months, which must take an enormous toll on the mental health of providers.

Janet Tamaren is a family physician and author of Yankee Doctor in the Bible Belt: A Memoir. She can be reached at her self-titled site, Dr. Janet Tamaren, and on Twitter @jtamaren.

Image credit: Shutterstock.com

Prev

"Call the family. Let them know she passed away."

October 12, 2021 Kevin 0
…
Next

When clinicians are bullied at a school board meeting [PODCAST]

October 12, 2021 Kevin 0
…

Tagged as: Primary Care

Post navigation

< Previous Post
"Call the family. Let them know she passed away."
Next Post >
When clinicians are bullied at a school board meeting [PODCAST]

More by Janet Tamaren, MD

  • Retiring from medicine: the good, the bad, and the ugly

    Janet Tamaren, MD
  • Balancing motherhood and medical school: tips from those who’ve done it

    Janet Tamaren, MD
  • How medicine is broken

    Janet Tamaren, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • Are patients using social media to attack physicians?

    David R. Stukus, MD
  • Physician Suicide Awareness Day: Where are the patients? 

    Jennifer M. Sweeney
  • You are abandoning your patients if you are not active on social media

    Pat Rich
  • Cancer patients who want to take unproven supplements

    Marc Braunstein, MD, PhD
  • Obstruction of medical justice: How health care fails patients with cancer

    Miriam A. Knoll, MD

More in Physician

  • Unveiling the secrets to effective resuscitation and overcoming obstacles

    Deepak Gupta, MD
  • A tense family drama unfolds as a young daughter pursues unconventional career path

    Osmund Agbo, MD
  • Decoding the brain’s decision-making: insights for medical professions and strategies for success

    Harvey Castro, MD, MBA
  • Unmasking the truth: the shocking reality of the opioid epidemic and who’s really to blame

    Jay K. Joshi, MD
  • Discover your true north: Navigating life’s confusions and embracing your path to success

    Tyler Jorgensen, MD
  • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

    Anonymous
  • Most Popular

  • Past Week

    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • Unveiling the secrets to effective resuscitation and overcoming obstacles

      Deepak Gupta, MD | Physician
    • Georgia’s new law promoting truth and transparency in health care credentials

      Carmen Kavali, MD | Policy
    • Physician employment contracts: the key to fighting burnout and improving working conditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • A tense family drama unfolds as a young daughter pursues unconventional career path

      Osmund Agbo, MD | Physician
    • Decoding the brain’s decision-making: insights for medical professions and strategies for success

      Harvey Castro, MD, MBA | Physician
    • Unmasking the truth: the shocking reality of the opioid epidemic and who’s really to blame

      Jay K. Joshi, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Extra Follow-Up Confirms Benefit of Nivolumab in Muscle-Invasive Bladder Cancer
  • Positive Signs for Lecanemab's Full Approval in FDA Briefing Documents
  • How Vax Skeptics Sow Doubt; Gun Death Every 11 Minutes; 90210 Star's Cancer Spreads
  • Insomnia Symptoms Tied to Stroke a Decade Later
  • Studies Question Role of CDK4/6 Inhibitors in First-Line Advanced Breast Cancer

Meeting Coverage

  • Extra Follow-Up Confirms Benefit of Nivolumab in Muscle-Invasive Bladder Cancer
  • Studies Question Role of CDK4/6 Inhibitors in First-Line Advanced Breast Cancer
  • For Some, Sex Is Better Sleep Aid Than Pill, Small Survey Finds
  • Skipping Radiotherapy 'Seems Safe' for PMBCL Patients in Remission
  • Promising Gene Therapy for Overactive Bladder
  • Most Popular

  • Past Week

    • A physician’s typical day, as envisioned by a non-clinician health care MBA: a satire

      Jennifer Lycette, MD | Physician
    • Is chaos in health care leading us towards socialized medicine? How physician burnout is a catalyst.

      Howard Smith, MD | Physician
    • Revealing America’s expansion: the dark truth of Native American suffering and unjustified abuses

      Anonymous | Physician
    • The tragic story of Mr. G: a painful journey towards understanding suicide

      William Lynes, MD | Physician
    • The rising threat of lung cancer in Asian American female nonsmokers

      Alice S. Y. Lee, MD | Conditions
    • From Moscow Mule to the opioid crisis: Unveiling the tragic legacy and urgent solutions

      Osmund Agbo, MD | Meds
  • Past 6 Months

    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
    • Unveiling the hidden damage: the secretive world of medical boards

      Alan Lindemann, MD | Physician
    • An inspiring tribute to an exceptional radiologist who made a lasting impact

      Kim Downey, PT | Conditions
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • Proactive risk management: a game-changer in preventing physician burnout

      Howard Smith, MD | Physician
  • Recent Posts

    • Unveiling the secrets to effective resuscitation and overcoming obstacles

      Deepak Gupta, MD | Physician
    • Georgia’s new law promoting truth and transparency in health care credentials

      Carmen Kavali, MD | Policy
    • Physician employment contracts: the key to fighting burnout and improving working conditions [PODCAST]

      The Podcast by KevinMD | Podcast
    • A tense family drama unfolds as a young daughter pursues unconventional career path

      Osmund Agbo, MD | Physician
    • Decoding the brain’s decision-making: insights for medical professions and strategies for success

      Harvey Castro, MD, MBA | Physician
    • Unmasking the truth: the shocking reality of the opioid epidemic and who’s really to blame

      Jay K. Joshi, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Patients should never underestimate the self-flagellation of the physician
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...