In The Healer’s Art medical school elective (http://www.ishiprograms.org/programs/medical-educators-students/), we discuss the “3 question journal” in which we look back at our day and ask, “What surprised me today?” “What touched me today?” and “What moved me today?” As I contemplated my day, spent at the American College of Phlebology’s annual Congress, I realized how moved I was by the final session, entitled simply “M&M.”
We physicians, sometimes accused of being arrogant or aloof, routinely hold these morbidity and mortality conferences in which we open our wounds for inspection and critique by our colleagues, hoping for some revelation of what we did that caused an unwanted result, or what we might have done differently to avoid it. I know of no other profession that ritualizes this type of intentional vulnerability and inspection of our mistakes, ignorance, or misjudgments. We do this, as we all know, because we constantly strive to be better. We want to offer our patients the very best. We wish to prevent every complication, even though we know that complications are not only possible but even expected. To discuss our failings requires a certain sense of safety. In this era of increasing litigation, evaluation of our decisions by insurance administrators, and repeated patient satisfaction evaluations, how does this sense of safety still persist?
As my colleagues bravely stood up to discuss their less-than-optimal results, they were joined by other physicians who had experienced the same difficulties. Everyone added his or her experience, opinion, and suggestions. I watched as the entire group struggled to understand and formulate a better path for the treatment of our patients. There was a sense of shared experience, of shared risk, and of shared commitment to a solution. The nobility of this endeavor, in which honesty and vulnerability are intentionally placed above ego, and in which people generously contribute to the safety that makes it possible, made me very proud to be a physician.