Moral Ambivalence

Two years ago a tragic fall and crushed arm started a long journey through the best and worst of the world of healthcare. Before the journey I, like most Americans, had childlike faith in the gods we call doctors. Our family physician, Dr. Roland, is one of the finest examples anyone can imagine. In addition to spending a month in Africa every year tending the needs of the poor, every day he truly heals his patients’ souls as well as their ailments. His advice to me after an orthopedic surgeon destroyed my radial nerve – causing far more damage than the fall ever did – was to have a nerve graft done immediately but far more importantly, to find a way to forgive the Doctor/God who had eternally destroyed my left hand.

Little did I know that as hard as the next seven surgeries would be, forgiving a Doctor/God would be infinitely more difficult.

My journey exposed me many of the finest hand surgeons in the United States: the likes of Lord Jupiter of Harvard, Lord Hanel of Seattle, Lord Viola of Vail, and the Great Lord Morrey of The Mayo Clinic.

As I told them my sad tale, the only thing you could see in their eyes was fear, quite an unexpected response from a God. Later I would learn that I was their worst nightmare, an eternally damaged patient who knew it. Their fear is so ingrained that it totally precludes any response of sympathy, anger, or disgust. They reside in a world without moral absolutes. It is a foggy world of outcomes – some quite miraculous, others quite tragic, but none that are either right or wrong and certainly not anyone’s fault. It is this moral ambivalence that makes Doctor/Gods so very difficult to forgive. Theirs is a strange world where you pledge your life to helping patients but spend most of your career working to preserve the God-like myth. The myth is perpetuated by quickly taking credit for the miracles and immediately burying the tragedies. Myths are a costly addiction for the Doctor/Gods for they give birth to expectations that can never be met. However, for patients, burying the truth is far more than costly. One of our oldest, most basic survival instincts is to understand the why, the cause of tragedy. Nietzsche wrote, “He who has a why to live for can bear with almost any how!” As a victim of medical error, I know first-hand that the questions of “Why?” are every bit as tortuous as the physical results of the mistake. Your mind constantly wonders, “Did I just hire the wrong Doctor/God, did I just schedule my care on a bad day, or the worst of all, is the real God very angry with me?” Perpetuation of the myth by burying the truth leaves these agonizing questions unanswered for the rest of our time on this earth. Jerry Sittser observed that our greatest fears in life are the totally random tragedies that we cannot predict, let alone control. Doctor/Gods by their silence make medical errors our greatest fear.

I believe that understanding why is the crucial first step towards ultimate forgiveness. All of us are highly imperfect beings who make mistakes every day. The truth is never hard to understand. Doctor/Gods’ greatest weakness is that they don’t understand that true forgiveness transforms both parties. It is a growth experience far more valuable than maintaining any mythic reputation. What can be done to dispel the myth? Our most valuable tool may be to be absolutely honest with the Doctor/Gods and strongly encourage them to be honest with us. When you encounter honesty, cherish it, praise it, and tell the world about it, for true honesty is quite rare.

The two things that all Doctor/Gods should learn early in their profession are that no amount of cash can replace competent compassionate care and that honesty can heal the soul when nothing can heal the body!

Last month was the much anticipated/dreaded meeting with my original Doctor/God. As much as I pressed, he didn’t want to talk about the details of what went wrong. So I explained what I thought happened. He hung his head and nodded a lot. He did admit that a lot of people messed up – badly – and said that it was probably not an EBI Technology issue but a national-level EBI problem (shipping the wrong parts). He explained that it was the second worst thing that has ever happened to him in his career, and that he lost a lot of sleep over me. His practice doesn’t do any more plunge incisions and will never use another elbow fixator. The doctor excitedly explained a new system of injecting botox into the elbow to prevent the buildup of scar tissue and heterotopic ossification but he didn’t seem interested at all in educating the orthopedic world about my problem, which drives me absolutely insane.

I told him my theory that God caused his mental lapse to teach me a few things about life. He said God taught him a lot also. Though I still didn’t know why this tragedy happened, I told him that I forgave him; he hugged me. The attorneys were touched (really). I truly hope that he feels better.

I cried all the way up the mountain on the way home for no explainable reason, though it was kind of symbolic as I cried coming down the mountain after the dislocation in October 2004 and cried all the way to Vail on the August 2005 infection cruise.  Blurry mountain driving: quite a learning experience.

Kerry O’Connell   2/9/07

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About Kerry O'Connell

Kerry O'Connell is a civil construction project manager and a member of the Colorado Health Facility Acquired Infections Advisory Committee. A committed patient safety advocate, he calls for restoring empathy and compassion in health care. He became a Numerator in 2005.
This entry was posted in The Spritual Side of Harm and tagged , . Bookmark the permalink.

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