So Sue Me
A few years ago I was getting ready to start a shift in the ER when a Code Blue was broadcast on the overhead PA system. I sprinted over to the medical floor. When I got there, a wide-eyed ward clerk pointed mutely at one of the patient rooms. Inside I found three nurses frantically trying to revive an unconscious nine-year-old boy.
Before I had time to ask what had happened, he stopped breathing. I snatched a pediatric ET tube off the crash cart and intubated him. With ventilation his oxygen sats quickly returned to normal. His pulse and blood pressure held steady, so no chest compressions were required. Within minutes most of my colleagues were at the bedside. Together we formulated a differential diagnosis for the respiratory arrest, initiated a course of therapy and contacted a tertiary care centre. A few hours later he was en route to a pediatric ICU via air ambulance.
To our dismay he went into shock and died a few days later. The news decimated us. A pall hung over our hospital for weeks.
I don’t often attend patient funerals, but I felt an overwhelming need to go to his. Not surprisingly, the church was packed. The air was so thick with grief it was hard to breathe. I usually have a firm grip on my emotions, but when the deceased child’s classmates joined hands and formed a circle around his coffin, I cried.
A few months later I was doing some charting at a workstation in the ER when a briefcase-toting stranger sidled up to me.
“Are you Dr. Gray?” he inquired.
“Yes, I am. How can I help you?”
He fished a manila envelope out of his bag and handed it to me. “This is for you.”
“What is it?”
“Notification.”
“Of what?”
“You’re being sued for malpractice.” He flashed me a jagged smile, turned spryly on his heel and left the department. Talk about schadenfreude.
I opened the envelope. Sure enough, it was a lawyer’s letter stating the parents of the deceased child were suing two colleagues and me. Having never been sued before, I was stunned. I contacted my legal representative immediately. After carefully analyzing the case, my attorney came to the conclusion I had been included in the lawsuit solely because my name had been recorded in the boy’s chart. The fact that the only reason it was there was because I had voluntarily responded to the Code Blue and helped with the resuscitation didn’t seem to matter. Apparently, malpractice lawyers like to cast a wide net in order to improve the odds of ensnaring someone. I was advised there was a fair chance I’d eventually be “cut” from the case. There was only one catch – it would take at least a year.
The first six months were sheer misery. My appetite vanished and I lost weight. I couldn’t concentrate properly and I developed gruelling insomnia. I reviewed the case in my mind so many times it must have worn a permanent groove into my brain. I could understand the existence of the lawsuit, but why me? What would my family and friends think? What effect would it have on my career? I cycled endlessly between fear and indignation. Sometimes apathy would set in, leaving me feeling hollow and indifferent. I became moody and irritable. Even my kids noticed the change in my behaviour.
In time, the obsessive rumination settled. I started being able to go longer intervals without thinking about the lawsuit. My appetite and sleep improved, and my interest in hobbies slowly began to return. A new steady state was evolving.
Approximately 18 months after my initial notification I received a letter from my attorney stating I had been dropped from the case. No one on the opposing side bothered to apologize for needlessly putting me through hell for a year and a half. I guess my feelings weren’t very high on anyone’s priority list.
A month later one of the parents of the deceased child telephoned me at my office.
“Dr. Gray?”
“Yes?”
“Can I transfer my family to your medical practice?”
“ What?”
“We’d like to switch doctors. Can we start seeing you?”
“I don’t think that would be such a good idea.”
“Why not?”
“Because you just tried to sue me! You ruined a year of my life!”
“Oh. Okay.”
Oddly enough, they called back two weeks later with the exact same request. My answer didn’t change.
Earlier this week I was working in the emergency department when we got word a child who had just undergone surgery was having a malignant hyperthermia crisis. As I ran to the OR to assist our anaesthetist, an unexpected thought popped into my head: For God’s sake, don’t go in there! If there’s a bad outcome, you’ll get sued! I still went, of course.
How can things have been allowed to deteriorate to the point where a qualified physician with training, skills and experience is tempted to not get involved when help is needed?
3:00 a.m.
Most people rarely witness 3:00 a.m., but I see it all the time. I’m a rural physician, so my schedule is frequently out of synch with the rest of society. Due to the small size of our town, it’s not unusual for my car to be the only vehicle on the road when I leave the hospital in the dead of night. Driving home alone across a frozen landscape at 3:00 a.m. can be depressing. The complete absence of traffic fuses with the darkness, the drifting snow and my fatigue to create a crushing sense of isolation. Sometimes I feel like I’m the last living person on the planet.
I park in our garage and lug my gear inside. As always, I am struck by how silent the house is at this hour. I hang up my coat and make my way to the kitchen. The supper I missed earlier is waiting for me in the fridge, but it’s far too late for me to have a full meal now. In the end I settle for a bowl of cereal. While I eat, I try to read the newspaper. Tonight the stories seem wispy and insubstantial, as if the events described all occurred in a distant universe. I toss the paper into the recycling bin and retreat to the living room. The curtains are open. An arabesque of silver ice crystals garnishes the edges of the picture window. I sit on the piano bench and watch the moonlit snow swirl across our yard.
Eventually I head upstairs. Partway down the hall I stop to check on our daughters. They look so innocent asleep in their beds with their limbs akimbo and their stuffed animals scattered everywhere. After retrieving the cast-off blankets, pillows and toys, I tuck the girls in and give them each a kiss on the forehead. The youngest stirs and awakens. “I love you, Daddy,” she murmurs. She hugs me, rolls over and returns to her dreamworld.
It’s good to be home.
Carpool Conundrum
Every Monday evening I sit in the subarctic bleachers of our local arena and watch two of my daughters figure skate. Their lesson runs from 6:00 until 7:00. About 10 minutes before the session ends I slip out of the building and drive halfway across town to pick up my third daughter at Beavers. Beavers also finishes at 7:00, which makes retrieving all three of them on time pretty much impossible.
If Beavers happens to wrap up early I try to swoop in, collar Kristen and race back to the arena before Ellen and Alanna get off the ice. Unfortunately, Beavers has a tendency to run late. Even when it does end on time, most nights Kristen doesn’t want to leave right away because she’s busy touching up her craft du jour. As a result, we usually wind up getting back to the arena several minutes after 7:00. Ellen and Alanna don’t like it when I’m late, but they try not to complain about it too much because they understand there’s no way I can be in two places at the same time. Jan can’t bail me out of this weekly predicament, either – she directs the town’s community choir every Monday, and as luck would have it, their practices begin at 7:00 p.m. sharp.
One Monday last October I was waiting impatiently for Kristen to finish off her Beavers’ Halloween project.
“Come on Kris, we have to go,” I said in that voice parents use when we’re trying to urge our children to get moving and they’re dawdling along as though they have all the time in the world.