I walked into the maternity ward to watch the fetal heartbeat strip during labour. The babys cardiogram was perfectly normal. As the line of dots slithered across the monitor, I thought about the little one wed just sent home with a very sick midwife, and how I now had to coordinate with another midwife from gynaecology to cover the reception area.
Is everything all right? the anxious expectant mother, Charlotte Whitfield, asked, peering into my eyes. Anything wrong on the screen? she pressed, her voice tinged with worry. You look so focused.
The hardest part of being a doctor is learning to keep a straight face. All our conscious life is spent traininglearning to diagnose, piecing together fragments until we see the whole picture. We learn to observe, to wait patiently, to intervene only when needed, and to snap into the right decision in an instant. None of us ever studied acting.
Imagine this: after a grueling operation, in the dead of night, with your eyes stung by icy water, you havent even had time to wipe the blood that somehow splashed onto your shoes, you descend to the recovery ward and greet the next patient with a genuine smile, calm and friendly. Thats the trickshow the frightened, bewildered person whos just been whisked in by an ambulance that theyre safe, that people are happy to see them, that help is on the way to ease, treat, and cure.
We were never taught that a sick person is terrified! No matter how seasoned we are, no matter how we handle the toughest crises, we must learn to keep a poker face, because fear warps realityboth yours and theirs. Outside the hospital doors your parents are ill, a child has lost their keys and is perched on a staircase waiting for someone, in the intensive care unit a pregnant woman isnt stabilising and the operating theatre nurse is having a hypertensive episode. All of it whirls in your head, yet somewhere above that, beyond your own mask
Keeping your composure is a monumental task, especially when you realise youre fifteen minutes from disaster. You have to conquer your own terror, issue clear orders, calmly explain to the patient why were in such a rush, soothe her and her relatives, get consent for surgery, then sprint towards the operating theatrehalfclothed, face still in place.
Later, when the drama has already unfolded, you must still keep that face, forgetting the cold that settles in your chest, talking and talkingto patients, their families, strangers, yourself, the Almighty, your own jumbled thoughts, your boss, and again to the families. Until the dreadful tightness in your chest eases enough for a full breath, and you recognise that the night shift has etched another scar on your heart.
An hour later, descending to see a new patient, you keep that mask on, grinding your cheek under your left collarbone. Because doctors make mistakes. Every single one. Even those who swear theyre sent from God. Theyre humanonly those who dont work at all get it right every time. Even the most precise machines err, because theyre built by people. To err is human.
The scariest part is realising youve messed up. Your mind keeps replaying the moment you could have done something differently, but theres no answer to what the outcome would have been. And that answer is forever out of reach.
When did you stare at a perfectly normal cardiogram with bloodshot eyes from fatigue? Your eyes have grown accustomed to that weariness over years. When did you overlook an entirely normal lab result that nobody else would have noticed? When did you calculate a drug dose strictly by the protocol and still get it wrong? When did you arrive too earlyor too late? When did you read an Xray and miss the obvious, or see something that wasnt there? Your vision is the same as it was yesterday, last month, a year ago.
When a scalpel slipped and a clamp clattered from a vessel, why didnt it happen yesterday, the day before, or a year ago? Maybe because six night shifts in two weeks is a lot, especially when your own mother is lying at home after a stroke. In medicine, time is relative, and your loved ones have been in the honour roll for decades.
The worst is not knowing exactly what went wrong, because then it might happen again. How many more textbooks, training sessions, sleepless nights will it take to prevent a repeat? No one can answer that. And how do you banish the nagging thought that statistics are on your side?
The grim medical statistics, spoken in cold numbers, tell us that out of a thousand births, operations, or procedures, there will be three to ten complications worldwideevery day, every month, every year. Someones life, someones health, someones tragedy.
So what does a doctor do when he finds himself in that bleak statistic? He stands before the devastated families and says, Here I am. Your murderer. Can anyone truly picture themselves in that position? Hundreds, thousands of sorrowful faces stare back, and you are the only reason for their unfathomable grief.
Im the one, you think. Destroyer. And why, when a doctor slips up once, are the countless times he was right erased from memory? Doctors err because theyre human. Gods dont make mistakes. Thats their world, their creation, their statistics. The more I work, the more I realise only a chosen few can grasp that grand design. We are not chosen. We are ordinaryordinary people, ordinary doctors.
