The healing power of “thank you”

Recently, I saw a patient die unexpectedly in the operating room. I consider myself mentally difficult, but it was the first time I had experienced such a situation, and the impact on me was much greater than I expected.

The fact that the patient had passed away was terrible, but after our futile and desperate attempts to save him failed, I still had to face the horror of telling his wife. I took a chaplain and one of my residents with me and met the man’s wife in a private patient conference room. There was no way to approach her gently. “I’m so sorry to tell you this,” I blurted out, “your husband died during the operation. Hearing these words, she started to scream and sob uncontrollably.

That night I couldn’t sleep. In my mind, I kept replaying the details of everything that had happened, and every time I closed my eyes all I could see was the look on the woman’s face as I uttered those horrible words.

The next morning, I canceled my clinic. I ended up taking several days off. When I returned to work, I felt like a dark cloud was hanging over me. My patient’s death had been an abnormal event. I was not careless or neglectful, but I was nonetheless overwhelmed by a complicated mixture of guilt, grief, questioning of my abilities and embarrassment. News of a patient dying in the operating room spreads quickly and unexpectedly.

Back at work, I struggled to face my colleagues and coworkers. In the operating room, I frequently work with a favorite scrub technician who was there when it happened. The first time we saw each other we both looked away and parted ways. It was still too cool.

My patient had been morbidly obese and plagued with a long list of health problems. His operation had been palliative for an incurable cancer. I tried to allay my grief and guilt by focusing on these details. I also called his wife and mother to apologize and checked with everyone who had been in the operation to make sure they were okay. Without a doubt, it all helped, but the black cloud hanging over me refused to dissipate.

I love my job as a cancer surgeon. However, it shook me deeply. I wondered if I could even continue. But then, slowly, rays of light began to pierce the dark place where I had been. Most were from grateful patients. I frequently share my personal phone number, and a little over a week after my patient passed away, I received the following text from a family member of another patient, along with a series of wedding photos:

“I just wanted to take a moment to thank you once again for saving my father’s life … because of you he was there! He went with her. [one of the sisters got married] down the aisle, had dad and daughter dance and had an amazing time with family and friends. This all happened because of you, and I just want to thank you once again from all of us! You gave us this time with my father and we will be eternally grateful to you! “

I knew the man in the tuxedo well in these photos. He had T4 laryngeal cancer, which, with black humor, had been called T7 during tumor counseling due to its extreme size. I had doubted that it would be possible to cure him, but we did.

Following this text message, it seemed that the patients began to express their gratitude one after the other. They didn’t know how much I needed it.

“You are my hero, Doc,” said a man who had survived a severe melanoma.

“I can’t thank you enough,” said another patient, who I had treated for recurrent tongue cancer, as he squeezed my hand over and over while looking me seriously in the eye.

But it wasn’t just the patients who were helping me. I also received a handwritten letter from a recently graduated Favorite Resident: “I can’t say enough about how much I enjoyed working with you,” he wrote. “You have been incredibly and profoundly influential on me as a physician and as a person.”

Maybe more patients and colleagues than normal suddenly started to express their gratitude, but I doubt it. The truth, I guess, is that I listened better because I suddenly needed to hear these things.

The emotions I felt because of the dying patient never completely disappeared, but in the weeks and months that followed, I managed to deal with this event. Looking back, I think the gratitude that was shared with me was a big factor in my recovery.

It made me think. Often in life, we fail to be grateful or properly express our gratitude to others. Another mistake, however, is not “hearing” or fully appreciating the gratitude that is expressed to us.

As physicians, despite our best efforts, terrible things can still happen to the people for whom we are responsible. Fortunately, however, these events are rare, or at least rare enough to be more than outweighed by the good we are capable of accomplishing.

Finally, the drama of my patient’s death made me more sensitive to gratitude. Being more sensitive to gratitude has helped me better celebrate the many lives that I have the privilege of caring for.

Thorsen Haugen, MD, is an otolaryngologist.

This message appeared on Kevin®.

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