I often compare the experience of a patient's unexpected outcome and living through malpractice litigation to running a marathon. It's intense and may feel harder in some ways than anything you've done before. You will almost certainly have moments where you feel like you are hitting a wall and cannot go on, and like any distance runner, you will need time to recover after the fact.
What Sets This Race Apart
A few things make this marathon different from most. For one, you certainly didn't volunteer to run it. Furthermore, no one can tell you at the outset how many miles you'll be expected to run.
Without a doubt, it takes time to heal when a patient's outcome startles us, whether or not litigation ensues. These events pack power for healers, whether or not we did anything wrong. Commonly, those who wonder whether they caused or might have prevented significant harm to their patient often remember the event in great detail for decades to come.
Plus, the process of litigation can be unpredictable. While some cases settle right away, others go on to trial or even appeal. While some defendants may be dropped, others are retained.
Often, neither you nor your lawyer can predict whether your race will be a mini-marathon or one of those ultra-marathons across the Gobi Desert, say.
Your Self-Care as a Runner
The unpredictability of the process makes it crucial that you immerse yourself in attending to your physical, mental, and spiritual well-being, just as great marathon runners do.
First and foremost, I encourage you to focus on self-compassion. Speak to yourself only as you would to a friend. Make room for tears and laughter.
Eat right, get your sleep, drink more water and less alcohol and caffeine. Steer clear of illicit drugs, and don't just fill the void with more work!
Do whatever you would if you were in fact about to run a hundred miles or more in the Gobi Desert.
Take time with friends and loved ones. Raise a dog. Get out into nature or into the arts or sports. Schedule a standing appointment for a massage twice a month even if you are still in training or paying off student loans. Do not hesitate to draw around yourself a psychologist, a coach, or a spiritual advisor.
Listen to the Voice Inside Your Head
Above all, take note of any little voice inside your head which suggests that life is not worth living. Should that voice pop up even once – as it does for many physicians in the midst of this tough experience – please, please remind yourself that these thoughts put your life in danger. To quote Mary Oliver, "Your one wild and precious life” is as valuable as that of any person whose life you have touched along the way.
Commonly, this experience produces a level of distress you may have never known before, even with all the tough things you have done. Do not delay. Seek out that care or someone who can help you to find it.
What it Takes to Win
For most marathon runners, winning is not actually about winning. Winning is simply about crossing the finish line. The same should go for you. If you make it through and come out with your heart and mind intact, you will have won!
Pour energy into accepting your own humanity and releasing any perfectionism. While it may feel like perfectionism got you into medical school, it now stands between you and your well-being. Embrace and forgive yourself and your patient for your humanity.
Let finishing this race with integrity be enough.
Hold tight to the words of Desiree Linden, winner of the 2018 Boston Marathon: “Just show up for one more mile.” In this race, that goes for us, too.