Eventually, the ability to enjoy myself seeped back into my life, one area at a time. My kids sucked me back into their world that didn’t care about my troubles so long as I could splash them in the bath or read them a bedtime story. My wife was simply extraordinary. I didn’t feel deserving of my family’s love, but they shared it all the same, and it rescued me.
On a given day I’m more prone to be sap than cynic, but reading and talking to anyone and everyone who’d gone through a lawsuit persuaded me that the medical malpractice system is impersonal but ultimately rational. Willie Sutton, a career thief in the 1920s, was asked by a reporter why he robbed banks. His reply, “Because that’s where the money is,” has come to be known as Sutton’s Law.
Understanding this law gave me the perspective to realize the lawsuit against me was not personal, but a rational response to an irrational situation.
Other developed economies have evolved safety net systems so that the unlucky souls who pulled a losing health care lottery ticket are still able to receive necessary care.
The closest the U.S. has come as a nation is our no-fault National Vaccine Injury Compensation Program. We know statistically that a tiny percentage of children who are vaccinated will sustain harm relative to the overwhelming majority who benefit from vaccination, and if your kid is harmed, the federal government has a kitty to help you cover the cost of care resulting from this harm. The rationale is that after a series of lawsuits threatened to stifle the development of vaccines, we adopted a no-fault approach to save the production pipeline and protect providers who vaccinate kids.
Our justice system (in contrast) is adversarial, designed to apportion blame and hold the liable party financially responsible. Without underplaying the role of negligence, which is real, there are many examples in healthcare where patients have bad outcomes irrespective of receiving excellent care from providers.
Left with little recourse (and no shortage of personal injury lawyers), patients sue their physicians “because that’s where the money is.” Along with hospitals, doctors have the deepest pockets thanks to their malpractice insurance, so it makes rational business sense from the patient's perspective - lots of potential upside.
Once I was able to see my malpractice lawsuit as a rational response to an unlucky patient’s tragic outcome, rather than as a referendum on my ability to take great care of patients, it freed me to take back my sense of purpose. It wasn't personal; it was just business.
The oddest part of this experience is that, in the years following it, colleagues in my group have informally referred other group members to me to talk to about what to expect in going through their first lawsuit. As with many high-risk specialties, in emergency medicine it’s less a matter of if and more a matter of when you will face a lawsuit over your career.
Learning to regard lawsuits as rational business decisions undertaken in a flawed system rather than personal assaults on one’s integrity allow you as a physician to emerge cautious but resilient, instead of burnt out and jaded.
Nonetheless, the stress that comes with this type of career can reinforce the value of financial independence as a goal worth pursuing, if only so that once you’ve experienced enough of this stress, you need not stick with it for the paycheck alone.