This is the 107th WILTW

The impact of a child dying in hospital on their family and friends is unimaginable. Whether expected or not there will be a void created in many peoples lives.

There is also an effect on the staff, especially when the child has been an inpatient for a while. Annabel Smith, a paediatric trainee from Australia, blogged this week on how to make sense of death in paediatrics. She writes eloquently on how staff deal with their own grieving processes and is honest about how difficult it can be to admit to peers how you are feeling. She notes:

“Doctors – medicine is brutal. It’s also wonderful, mysterious, joyful, and an absolute privilege to practise. A success can bring us to dizzying heights of elation, but every failure rocks us to our core.”

Failure is not a concept that sits well with the medical profession. There is an intrinsic desire to do good. To benefit patients with your actions and practice to a high, evidence based, standard. Whether it be through poor exams results or difficulty learning new procedures not performing well is uncomfortable.

There is also a natural tendency to equate patient outcomes with a direct result of your interventions. This is obviously a false premise. There are things that medicine, however well applied, cannot fix. And there is even a speciality,  palliative care, that has inevitable results for patients. Its patient centered outcomes being that death is as dignified and pain free as possible.

You still feel like you have failed when tragedy has occurred. I suppose it is human nature and perhaps a mechanism of demonstrating you retain the empathy that medicine could so easily remove from you.

There are other more definite failures in medicine though…

Failing to wash your hands.

Failing to introduce yourself.

Failing to be compassionate in your approach.

These seem so self evident that is it is difficult to understand how they don’t occur. Yet evidence suggests they continually don’t. I wonder if they are seen as failure though? What if the visceral response to these events were as powerful as those created when a patient dies. Would they occur as frequently?

What have you learn this week? #WILTW

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