My malpractice case was a blessing in disguise

My malpractice case was a blessing in disguise

This doctor had allowed work to come before family. A lawsuit led him to reassess his priorities.

By Kelly Pomerenke, MD
Family Physician/Sioux Center, IA

I've committed malpractice.

Not as a physician, but as a husband and father.

It took an actual malpractice case to open my eyes to how I had systematically shortchanged my wife and two sons in the name of medicine.

Residency training had prepared me for medical malpractice suits. Program directors and attendings always said it was a matter of when, not if. But what did they tell me about balancing my private and professional lives? Hardly anything.

From my perspective, medical education cultivates a dysfunctional lifestyle. Spend every spare moment at the hospital. Do whatever your instructors demand, regardless of how it upsets your home life. And at home, read constantly so you can answer the questions you're hit with on rounds. In short, put career before family.

I got caught up in the system. I routinely worked 70- and 80-hour weeks. Fun times with my wife and sons were few and far between. When I did attend a party or school function, I was too tired and distracted to enjoy it much. Teresa and I took vacations, but I brought paperwork along.

I should have seen the warning signs that I was headed down the wrong path. The first sign flashed during my residency. Aaron, my older son, developed H. influenzae meningitis at 18 months and spent 10 days in the hospital. You'd think I would have requested time off, but I visited him only when I wasn't busy fulfilling my training requirements. I provided Teresa scant comfort or information about Aaron's course of treatment. He got better. I didn't.

The second sign occurred when Teresa was pregnant with Jason. Severe bouts of morning sickness frequently left her bedridden. I blindly kept working when I should have spent more time at home caring for her and Aaron. Instead, my wife had to rely on a neighbor for help.

I missed a third warning sign in my second year of private practice. My otherwise healthy 59-year-old father, who was about to retire from farming, suffered an inferior myocardial infarction. A physician friend who was caring for him at a nearby hospital paged me stat. He told me they had given my dad streptokinase and were transferring him by helicopter to a tertiary care hospital. What did I do? I chose to see all my scheduled patients that afternoon before driving out to visit him.

By the time I arrived, he had already coded in a cardiac catherization lab. Fortunately, the doctors revived him. I should have been there for my father during this crisis just as he had been there for me so many times in my life. The tertiary care hospital was only an hour away. But it was a trip I foolishly postponed. He died two months later.

One spring day in 1996, the county sheriff knocked on my door and put some papers in my hand. I was being served with a malpractice suit. Two years earlier, a trauma patient had been brought to the ER after falling off a tanker truck. I happened to be on call, so I admitted him after ordering various X-rays and tests. The man died from a ruptured spleen later that day. His family sued me, saying I should have diagnosed the ruptured spleen, even though there was no evidence of it in the ER. Even the man's regular doctor, who took over the patient several hours before his death, hadn't detected the problem. (Incidentally, he wasn't sued.)

I was devastated. At 30, I had been in private practice for two years. I was just beginning to think that all my study and sacrifice had been worthwhile—that I had made the right choice. I loved being in the exam room. I loved getting to know my patients. And now I'd been sued. For the next two and a half years, terms like "negligent" and "careless" cropped up in endless, punishing depositions.

I came close to scrapping my MD. Maybe I had made a poor career choice, I bitterly thought to myself. I'd given up so much for the sake of medicine, and my reward was a malpractice suit. Was this all life had to offer?

The answer was No. I still had my long-neglected family. My wonderful wife and kids proved to be a great comfort during the ordeal. Teresa spent hours listening to me recount the ups and downs of the litigation. When I talked of quitting medicine, she reminded me about the things I'd miss, such as patient contact. And when I needed time alone to mull things over, she gave it to me. Her goodness stood in sharp contrast to my selfishness earlier on. Not surprisingly, our relationship deepened.

My life eventually rebounded. First, the malpractice jury found in my favor after a two-week trial, although I was too bruised to feel like a victor. And second, I made a new commitment to be there for my family.

To carve out more time for Teresa and the boys, I closed my practice to new patients. I also cut back on my hours. I log as few as 50 a week now—not a light workload, but lighter than it was.

As a result, I'm able to do things I used to think were incompatible with medicine. When our family goes on a vacation these days, I leave the paperwork behind. I throw the football around with Aaron and Jason, and we see movies together. I pitch in on household chores, too, instead of leaving them all for Teresa. (I've even been making scrambled eggs.) And Teresa and I go out to lunch and dinner more often.

I'm still not the greatest husband or father in the world. But I'm making progress. Today, I'm guided by the words I Am Third. That's actually the title of a book by the former Chicago Bears halfback Gale Sayers. God comes first. My family and friends come second. I'm No. 3.

I used to think I didn't have any choice about my old iron-man lifestyle. I don't think that way anymore. I no longer tell myself, "Someday, I'll do this or that with my family." Too many of my patients have told me how they regretted indulging in this "someday" syndrome. Their children grow up, and they don't know them.

Am I still glad that I chose to be a physician? I'm more content than I was, but only because I've achieved better balance in my life. I've got my priorities straightened out. After all, the most important family in a family practice is your own.

 

Kelly Pomerenke. My malpractice case was a blessing in disguise. Medical Economics 2000;7:181.