Second Victim Syndrome-An anesthesiologist's personal reflection

           Even though I have been a practicing anesthesiologist for over twenty years, last year was the first I’d heard of Second Victim Syndrome. In cases of medical error, the first victim is the patient, while the second victim can be anyone (physician, nurse, pharmacist, paramedic) who was involved in that error. 

           However, even when no medical mistake occurs, the psychological trauma of a patient’s unexpected death can leave the same trail of anguish, anxiety, and helplessness among the health care team as if it was our fault. Every doctor and nurse I know has at least one unexpected patient death seared in their memory. I unfortunately have a few:

            The infant with necrotizing enterocolitis that the surgeons could not save; I swaddled the infant, and with tears falling, placed him in his mother’s arms so he could die enveloped by love and not operating room steel. I carry the image of her hand, stroking his cheek, eighteen years later.

             Or the two-year-old girl with the bow in her hair, who was the same age of my niece at the time, brain-dead after her babysitter shook her to death, i.e., “shaken baby syndrome”; as the surgeons harvested her organs, I administered drugs to maintain her blood pressure. And when they finished, I turned off my machine, called my sister and wept. I held my niece and prayed for her continued health.

             Or my middle-aged patient, the routine orthopedic case, who coded on induction of anesthesia and never woke up. After hours of resuscitation, again, all that was left to do was pray. I hugged his wife as the surgeon and I conveyed the news. Her children surrounded her. I cried that night as well, as my empathetic husband, a former army medic, held me and reassured me until I slept.

           The memory of these patients, and their families’ utter anguish, stays with me. There was nothing I could have done to save them, nothing I did wrong. Trust me, I’ve researched every aspect to find my mistake. I’ve lost sleep, questioned my career choice, and sought mental health counseling to manage the stress of their loss. But the pain of their unexpected and tragic deaths lingers- like the torn knee tendon that heals but still throbs. I can walk on it, but it will occasionally start to ache—a reminder of trauma.

To my colleagues, you are not alone. Please seek mental health care if you are experiencing suicidal ideation. https://suicidepreventionlifeline.org/