Operating Anxiety

[DrQuakerJack]

Advertisement - Members don't see this ad

I am a new fellowship grad and out on my own for the first time, but I am also starting to lose sleep regularly worried about patients. I realize some of this is part of being a doctor, but I am concerned it is actually starting to interfere with my wellbeing. Is this common in the first year of practice?

 

[MstaKing10]

Describe it more. Is it before surgery or after? Are you handling some really tough cases or all pretty straight forward? Have you had complications?

Obviously some degree of anxiety operating solo first few years out of training is normal. Interfereing with your well being is a significant problem. Have you talked to your fellowship director or other mentor about it? Do you feel that your training is lacking in some way or are you confident in your skills? Lot more to unpack here but thanks for sharing. Takes courage to speak about this kind of thing and I'm sure you will find a lot of support (or at least I hope you will).

 

[DrQuakerJack]

I don't want to be too specific but I have had a couple complications (nothing crazy) - they were atypical cases going into the case. I generally get some nerves before surgery but most of the anxiety is related to a couple specific cases that did not go as planned. They were not just standard phacos though and generally I am fine with those.

 

[MstaKing10]

Any surgeon that operates willl have complications. Don't let anyone tell you different. And you care because you are a compassionate human being, that's normal. It's different having a complication as a fellow and having your attending bail you out or handle the reprecussions. Now you own it. That's an emotional experience unlike any other. You will get better at managing that. And as time goes on those will be fewer and farther in between. I've been an attending for 8 years and still recall the few complications as if they were yesterday. That's how you grow and learn. Nothing wrong with that.

 

[Dusn]

I’ve had the same issue. I’m pretty sure I can remember every bad outcome I’ve ever had. All the good outcomes, I forget unfortunately.
On the plus side, it will make you a better doctor - because you’ll learn from all your mistakes and you’ll remember all the bizarre cases even years later.


So the positive is that based on what you said I pretty sure youll be a very good doctor. The negative though is that it is a strain mentally and could possibly lead to burnout. I don’t have a good solution except to try to focus on your good outcomes as much as you bad ones.

 

[hello lady!]

I’ve had the same issue. I’m pretty sure I can remember every bad outcome I’ve ever had. All the good outcomes, I forget unfortunately.
On the plus side, it will make you a better doctor - because you’ll learn from all your mistakes and you’ll remember all the bizarre cases even years later.


So the positive is that based on what you said I pretty sure youll be a very good doctor. The negative though is that it is a strain mentally and could possibly lead to burnout. I don’t have a good solution except to try to focus on your good outcomes as much as you bad ones.

100% agree. I can recite the names of the patients I've had complications on 5+ years ago. All of the successful cases and praise you will forget because that's what you expect to happen. The same goes for patient reviews - all of the positive ones get drowned out by one negative feedback.

I remember being excited when I had a week where I wasn't operating - I would make the joke that I was guaranteed to go a full week without a complication. It's stressful because you'll feel like a failure to yourself, your partners, your referring providers, your staff, and your patients. Just keep your head up and as long as you still care enough to be stressed out then you know you're in the right place. It took me years to shed this feeling but it eases with time. I developed a ton of superstitions in the meantime (which is probably unhealthy but they seemed to help - it gave me the feeling of some control). What to eat the morning of, what to do the night before, etc. I still carry some of them with me to this day. I also dealt with the complications enough that now I'm comfortable that if something happens I can just deal with it routinely.

Hang in there!

 

[RetinaDude]

I love surgery. Truthfully, I am so much more relaxed in the OR than in the clinic. But, it can still be very stressful and humble you in a heartbeat. Just when you think “I’m the best surgeon in the world”, a complicated case (or complication) will come along and slap you back to reality. If you were a good surgeon in training, and did not require a lot of hand holding, then you will also be a good surgeon post residency. Don’t forget that. You have the training but now you have to remember you are that skilled surgeon. Take your time, but also pick your cases. If you go looking for complicated cases, you are going to have increased complications. Good luck!