“I may have experienced PTSD, causing memories of that event to be very deeply etched. I can, after 25 years, describe her in fine detail, down to the dress she was wearing and her hair-do. No other patient remains so clear to me.”

Yesterday, the January issue of JAMA was published. I authored a piece entitled What I Learned About Adverse Events From Captain Sully: It’s Not What You Think. Of course, this publication is a proud moment for me, since JAMA is the most widely circulated medical journal in the world. I have been very excited ever since it was accepted, and looking forward to the professional satisfaction of seeing it in print.

Today, I was fully immersed in an intense simulation – 22 anesthesiology residents completing four simulated emergency situations. When I emerged and the end of the day, my email was overflowing with messages from people who had read the piece, and whom I will likely never have the pleasure to meet. These messages shared stories from peoples’ darkest moments – extremely personal anecdotes – and are reflected in the short excerpts included in this post in italics. Thank you, fellow physicians, for sharing your deeply private experiences with a complete stranger like me. I have enormous gratitude for the honor of receiving them, and it is my hope that this article helps to move our profession and our humanism forward.

JAMA article January 2015

When I was an intern in 1969, a relatively young hospitalized woman (30s) died suddenly.The attending was so distraught that after meeting with the family, he turned to me and said that he had to leave and asked me to cover the service for the rest of the afternoon. I was aghast and thought that he was abandoning the other patients. Now 45 years later, I understand why he did what he did.”

“In 1983, when I was training as a cardiologist, on the first occasion that I used an Amplatz catheter (different from the usual Judkin’s catheter), as I cannulated the left main coronary , the vessel dissected (I dissected the vessel?), and after hours of aggressive resuscitation attempts, the patient died. I was never blamed. But I was devastated. Nonetheless, I was expected to be (and was) back in the cath lab the next morning. Over the years, I’ve never forgotten that patient or the events of that day. Now, 32 years later, after a successful career as an invasive cardiologist and nearing retirement, it still haunts me.”
“Ten years ago I spent six months in Sudan with MSF. A lot of “bad stuff” happened to patients, though I never felt personally in danger. I have never really gotten over it. I kept a journal of that time. After ten years I still can’t open that journal. I’ve never told anyone this.”
“I’m a retired emergency room physician and was one of the first to go through the certification process. I practiced in the busiest emergency room in Montana back in the 70’s and 80’s and I worked alone. The busier I was the more I liked it. But now I know that it took a toll on me. I just remember that there was a lot of heartache at times. I remember with all the sadness and crises that was going on around me, I just didn’t have time to grieve with the patient’s or their relatives or really think about what had just happened. There was always a patient waiting to be seen. [For the next ten years after my medical career ended] I had dreams about being in the ER. I have very vivid dreams and in the ER dreams there was always some crises and I didn’t want to be there! My wife is convinced that my dreams are indicating PTSD. She maybe right. You raise some very interesting questions in your excellent article. Thank you so much for taking the time and thought to write it and I will make sure that my physician son, Jason, gets a copy of it.”

You can read the entire article on JAMA’s website by clicking on the article image above.

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