PROFESSIONAL LIFE
I realize now this roundabout form of victim-shaming
was only a subconscious way to try to protect my
mind from the truth: One day this was going to
happen to me.
Medical errors are exceedingly common, both in
human and veterinary hospitals. Yet even though
everyone makes mistakes, almost no one is talking
about them. Not to each other, not to the public,
sometimes not even to our closest friends or loved
ones. Why? Shame.
Defined by my personal hero Brené Brown as a fear
of disconnection and unworthiness of belonging,
the avoidance of shame is at the heart of every
perfectionist. Be perfect, and everyone will love you.
Slip up, and you will be exiled. And so, when we do
inevitably make a mistake, we suffer in silence. We
fear that we are alone in our failure and that there is
something critically wrong with us.
We do what we have to in order to get through the
moment. Then maybe we go home and cry or fall
into a bottle of wine or a Netflix binge to numb the
doubtful thoughts that whisper, We shouldn’t be
trusted with anything that anyone loves for the rest
of our lives.
Maybe we wake up the next morning and think about
not going to work, that day or ever again. Maybe we
go to work, but we have such high anxiety and fear
that we can’t function. Maybe we leave the field. .
Maybe we take our lives.
This happens too much, and for the health of our
profession and everyone in it, it has to change.
It’s well-documented that both patients and caregivers
experience trauma, stress and grief related to medical
errors. Administrative processes and protocols often
focus on assigning (or denying) blame and punishing or
removing those involved. There are rarely procedures
put in place to address the systemic flaws that lead
to errors or to help those who have committed the
mistake, commonly referred to as “second victims.”
In fields where only the most exceptional get through
the academic and professional rigours required to
succeed, it only seems natural that the field becomes
self-selecting for perfectionists. And sometimes a
perfectionist runs up against the cold, hard truth that
sometimes bad things will happen no matter what
you do. Even more difficult? Sometimes bad things
will happen because of what you do—that jarring
reality is nearly unbearable. We are told from an early
age that we must be good, not just do good. And so,
when errors occur, our self-talk is not “I did something
bad,” but rather “I am bad.”
A 2009 study describes the healthcare provider as
a “second victim” after adverse patient events. 1 The
study also shows that there are three themes that
emerged in providers’ long-term recovery from a
medical error:
Thriving. We are able to put the event into
context and realise that we are imperfect —
but still good — doctors. We build our personal
resiliency. We work to learn from the mistake
and make our workplace safer.
Surviving. We “move on” in a literal sense, but
only because we feel we have no choice. We
repress our feelings and discussion about the
event. At best, we can function with no visible
adverse effects, but no added wisdom. At worst,
we continue to be traumatised by the memory
of the event. We overcompensate, double- and
triple-check, micromanage our staff, and harbor
a deep distrust in ourselves.
Dropping out. We can’t live with the memory of
our mistake or the fear and certainty that we will
make another one. We feel paranoid, depressed
and hopeless. Feeling unredeemable and
untrustworthy, we may even contemplate self-
harm. Dropping out may involve ceasing the
performance of a certain procedure, changing
fields or leaving the profession altogether.
So what helps? How do we process mistakes in
a way that allows us to walk the path of long-
term resilience instead of repeated trauma?
To this, I’ll add my personal thoughts, with the
disclaimer that my only credentials are that I
am a flawed, human veterinarian who walked
away from a good job that I was really good
at because I was too afraid to make another
mistake.
vet360
Issue 02 | MAY 2019 | 16