Magazine article Clinical Psychiatry News

Guest Editorial: Dealing with Complications

Magazine article Clinical Psychiatry News

Guest Editorial: Dealing with Complications

Article excerpt

Complications are ubiquitous in medicine. But most of us are poorly equipped to handle the psychological effects of severe complications.

The effects of complications can be devastating for the doctors involved. But medicine does a poor job of acknowledging the deeper effects of complications. Medical training must change, so that it teaches practical ways for clinicians to deal with these issues. Such training would help physicians do a better job. as well as maintain their own mental health.

Most doctors receive little or no training on dealing with the personal sequelae of complications or on handling the severe stress that these situations can cause. Traditionally in medicine, the personal response that physicians have to complications has been learned, not taught--and that is part of the problem. Many physicians have told me that the complications they experienced early in their careers had changed their practice and negatively altered their conduct.

Early in my career, a patient of mine had a severe complication. I was performing a procedure aimed at resolving chronic pelvic pain associated with a vascular malformation. During the procedure, the patient had a massive pulmonary embolism and died. It was a wrenching experience. In my mind I replayed over and over the decisions that led to this tragic outcome. For weeks, I felt remorse, self-doubt, and recrimination. The experience made me sharply aware of the negative personal and professional dynamics that a complication can trigger.

When I shared my experience with other doctors, almost all said that they had dealt with similar episodes in an almost identical manner, and all strongly agreed that they were not prepared to handle the event in a healthy way. …

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