“Holding anger is a poison. It eats you from inside. We think that hating is a weapon that attacks the person who harmed us. But hatred is a curved blade. And the harm we do, we do to ourselves.” –Mitch Albom
“The swelling can be normal,” they said. “Keep an eye on it,” they said.
My thoughts replayed their medical error again and again. While we “kept an eye on it”, the clot growing near his implanted port grew slowly larger over the next two months. He mentioned the warning signs of swelling and pain in several appointments but was ignored. Suddenly, without warning, he collapsed. In one terrifying heartbeat, I had nearly lost everything important to me in this world.
His near death wasn’t the product of a single medical error, but his oncology team had dismissed his symptoms several times. Even the nurse on the weekend help line, who consulted with the on-call physician had told him to follow up with the clinic the following day. This pattern of not listening to him had nearly cost him his life.
My husband was polite and kind with his healthcare team just as he was with everyone in his life. When the doctors told him that his symptoms were normal, he didn’t push it. But when the blood clot had gotten so big that it was starting to block the blood return to his heart, he nearly collapsed on a tennis court. Thanks to a team of interventional radiologists that removed the blood clot, he got a second chance.
Aftershocks from this event haunted me. My body moved through the motions of daily life, but it was just a shell. A dreamless, thoughtless version of myself that was was numb. An empty, thoughtless, and dreamless space inhabited my body. A long shadow from this incredibly black day seemed to block the light of my soul.
How could I trust that they would listen to him in the future? If they knew anything about him, they would know that he doesn’t complain. Nothing diffused my anger, so it festered and grew inside me. No call came from his doctor to check how he was doing. Just a call from the nurse on his team after he returned home from the hospital.
When a patient nearly dies, you take the time to call them personally. Period. Were they so used to patients dying and nearly dying that this event had become routine?
The follow up visit with his oncology team occurred 10 days after he nearly died. More than anything, I wanted an open and heartfelt apology for the many times that they had ignored his symptoms. I also wanted someone to recognize the gravity of their error and tell me why it wouldn’t happen to anyone else. He could have died suddenly over a long period of time. It was a miracle that he didn’t.
The fellow oncologist in-training was the first to see us in the clinic. He came into the room with a big smile on his face. But it evaporated after one look at our somber faces. His eyes widened as we explained what had happened. It seemed as if he hadn’t realized the severity of the events that had transpired.
“I am sorry this happened to you,” he said with his dark eyes full of care for my husband. His request for forgiveness was genuine and his eye contact and empathy helped ease my pain. I could forgive him, but I wanted more from his attending physician than a mere apology. Someone needed to tell me how this mistake would be avoided in the future. Everyone in the system needed more training to recognize these symptoms. I didn’t want another family to lose their mother or their father to a similar mistake.
When the fellow physician left the room to get the attending physician, my husband and I looked at each other.
“At least he said that he was sorry,” my husband said. I nodded to give my husband reassurance. But in my head, it was clear that this was not the excellent cancer care that we hoped he would receive.
The attending physician entered the room and took a seat next to my husband while the fellow physician stood behind her. Sitting down before you begin a difficult conversation with a patient was important to make them feel like they have been listened to – even when you are running behind in a busy clinic. This was the first step in making a patient feel like you cared about their problem, and I was hoping that it would precede her apology. A neat and clean apology.
“I am sorry for the hiccup in your care,” she said with eyes locked on my husband.
Hiccup? Did I hear that correctly? What? I couldn’t believe what I had just heard.
A hiccup is an accident that can happen to anyone. It is unexpected. An annoyance. A hiccup has no consequence for anyone’s life. It lasts a second. A trifle, a tiny irritation. A hiccup is forgettable.
This wasn’t an apology. She was sweeping away his near-death experience and her culpability. She was also dismissing the impact that this had on him, myself, and my girls.
“Hiccup…hiccup?” I cried. “He nearly died! The warning signs were there!” He had complained about arm swelling for more than a month. They would know this if they had read their prior notes. Had they not read their prior notes to check if they could have prevented this?
Never have I felt such hatred in my life before. I wasn’t angry. I was full of rage. Anger spread from my chest to every part of my body and the poisonous emotion seemed to flow through my veins. Tears welled up in my eyes. My brain couldn’t process this offense.
Meeting my gaze, the attending physician had an equally intense look in her eyes. But even more memorable was the shaking. Her face, head, and body were shaking. She had lost composure.
Our eyes locked for a full three seconds.
I didn’t know what would happen next. Was she fearful? Or being defensive? Was she angry at me for losing my temper?
In the past, I was quick to give people grace for their mistakes. But I couldn’t forgive them as long as the attending physician hadn’t truly apologized. And saying that this was a ‘hiccup’ didn’t come close to an apology.
I had no grace left for anyone. My brain was on fire again.
I am furious for you. "Hiccup" indeed. "I am so sorry your husband almost died. We have reviewed our procedures and implemented the following changes so it doesn't happen to you or anyone else ever again." Is that so hard?
Wow, Kristina, as I read your words, it feels as though I am reliving my husband's cancer journey. Your advice on grief and grace are spot on, maybe a little more embellishment of your own grief. Forgiveness should be a chapter of it's own. Grief and forgiveness go hand-in-hand as your mind adapts to the new reality.
Very well written, easy to digest and it brings me in emotionally.