I’ve wondered whether surgeons get any training on how to manage their own emotions when major complications occur. It must be difficult enough facing the patient and / or the family, without having to deal with their own state of mind.
After my complications, it’s easy for me to find fault in how my surgeon dealt with the situation, but how would I have coped if the tables were turned?
There’s no denying that I’d find my emotions overwhelming. My instinct would be to avoid the patient, but that obviously isn’t an option. My heart sinks at just the thought of having to face the patient in that situation. I can visualise myself (if I were the surgeon) having to take a deep breath before pushing myself into the patient’s room. I’d try and block out all my emotions, working on automatic pilot to get the job done. I’d want to sit down at their bedside, and ask them how they were coping, but would worry that talking would only make me feel worse. I can imagine my patient viewing me as uncaring, and would be angry with me. They wouldn’t know that that was the opposite to how I actually felt.
In the other extreme, where a surgeon is too open with their emotions, they may come across self-centred, the patient needs to believe that the focus is on them.
The more I think about the surgeon’s perspective, the more I realise how impossibly difficult it must be for them. Each must find their own way of coping when major surgical complications occur, not just for the one specific patient, but for the course of their career. However, what is equally important, is for that surgeon to consider whether their own coping mechanism will have any detrimental impact on their relationship with their patient, and their patient’s mood, and what they can do to mitigate this.
In my example, there are certain tasks that the surgeon mustn’t avoid, such as listening to the patient’s perspective and telling them that they are sorry. [My advice, the same as any job that you don’t want to do, is to put time aside, maybe pre ward round, and just get it over and done with. Often the most dreaded tasks are never as bad as people expect, and hopefully you will gain reward from knowing that you have done the right thing.]
However, there are other aspects of supporting the patient’s emotional needs that can be shared by the team, for example anyone can remind the patient that the surgeon is thinking of them. As simple as, post ward round when tasks are being allocated, the surgeon can add “and can you remind the patient that I’m sorry”.
Surgical complications should never be the elephant in the room, patients want to know that their stories have been heard and lessons learnt. Equally, junior doctors need to learn how to handle difficult conversations. Therefore, another option is for junior doctors to spend time with patients who have suffered major complications, talking about emotions, how the patient is coping, what was done well, and what could have been done better. These conversations will help the patient feel better supported, and any significant concerns can be fed back to the surgeon.
These are just two examples, there are many healthcare professionals involved in the patient’s care, each one can participate in supporting their emotional needs.
After major surgical complications, it’s easy when concentrating on the patient’s immediate medical care, to lose focus on the patient’s emotional needs. Patients need help in coming to terms with their experiences, part of learning to forgive, so that they can move on with their lives. I appreciate how incredibly difficult this must be for surgeons, however throughout they need to retain their own emotional awareness. Only by recognising that their own coping mechanism may have an impact on their patient’s emotional state, can they take the appropriate mitigating action, to minimise the risk of any secondary harm to their patient.
More than just physical 