Joy Commeth in the Morning
By Andrew M. Seddon, M.D.
Today's Christian Doctor, Spring 2008, Volume XXXIX, Number 1.
One doctor's journey through shock, self-doubt, anger, anxiety, frustration, and depression due to a malpractice suit to joy again.
The letter came on a gray November Monday, a busy day in the urgent care department where I work. It bore the blue and white logo of the Montana Medical Legal Panel, the official state body composed of three lawyers and three physicians that assesses the merits of malpractice cases. I opened it without concern, thinking that I was being asked to serve on the panel. Instead, I was shocked to learn that I had been named in a malpractice suit.
I still don't know how I made it through the remainder of the day, or how my shaking hands were able to suture the next patient's laceration. Instantly, the joy was gone from my life.
For the next six months, until my case was heard, I was in the grip of the most intense, unrelenting anxiety I had ever known. Nothing - not the stress of medical school, not the pressures of residency - could even come close.
And there was no way to relieve it. It wasn't a bad dream from which I knew I would awake in the morning. I couldn't wish it away. The reassurances of my clinic's risk managers and defense lawyer couldn't alleviate the constant gnawing.
The facts of the case were simple. Years earlier, on one occasion, I had seen a teenage girl with a known history of anxiety for the same complaint. Some thirteen months later - during which she had seen other physicians for different complaints and received sports physicals from her pediatrician - she was found dead on her couch. When her cousin died in a similar manner two weeks later, Long QT Syndrome - a disorder affecting the electrical conductivity of the heart- was suspected. Even though the most common presenting symptom of Long QT Syndrome is sudden death, her mother blamed me for not detecting it.
For six months, I suffered. And my wife suffered with me. I was a poor husband. Work was an agony. I slept poorly. I hated every day. I was full of doubts - about my abilities, my competence, my calling, my worth or lack thereof. I was full of questions - Why me? Why was God allowing this? Didn't He care? Why didn't He protect me - wasn't that His duty as the Great Physician toward a junior physician?
I was angry. Not at the bereaved mother, but at the lawyer who was pressing the case and the system which allowed it. I was anxious, angry, frustrated, and depressed. I could well understand why some physicians left the medical profession after such an event.
And the anxiety didn't end with the Montana Medical Legal Panel hearing. Even though the panel ruled unanimously in my favor, the statute of limitations still had ayear to run ... another year of torment, waiting to see whether the plaintiff's attorney would decide to pursue the case (in the end, he didn't).
More than once, I came close to throwing in the towel. I desperately wanted to hand in my resignation and never see another patient. I didn't want to risk another lawsuit.
But I didn't throw in the towel. I wasn't a quitter. didn't want to give up. I had survived all the abusesI that medical school had thrown at me, and I wasn't going to yield now, especially when I knew I had done nothing wrong.
My wife, Olivia, was a tower of strength. She provided unfailing inspiration. She was endlessly creative in efforts to ameliorate my mood - taking me sledding, on overnight trips, baking cakes, and introducing me to running (an activity that would pay benefits later).
God's ways of working were not always immediately evident. He provided no instant answers or relief. There were no miracles, no sudden revelations, no quick cures. There were times when it didn't even seem as if He were present. And yet He was active behind the scenes, uti I izi ng a variety of methods to bring me through this particular "valley of shadow."
Only hindsight makes the picture clear. As I compare my I ife now with how it was at the start of the process, I can see the differences God has made. He used the instrument of prayer. Even though there were times when I thought no one was listening, God was. When I didn't have the words to say, Olivia came to my rescue, interceding for me, as did my parents.
He used my love of writing. At first, I simply chronicled my feelings and the events that transpired, searching for relief, for understanding, for help. But then the prayers and the writing began to coalesce. Bible passages, sermon fragments, pieces of music, glimpses of nature, phrases from books; all seemed to contain messages from God - expressions of comfort, reassurances, summonses to obedience, exhortations tostrength. I wrote them into a series of devotionals so that they could speak to me again, and that their messages would not be lost. The following is excerpted from the "diary " that resulted:
I heard a phyician xaution against expecting vindication at the conclusion of the malpractice process. "At the end," he said, "all you'll walk away with is the love of your wife." In other words, there will be no restitution for us, no recompense for our anguish of heart and soul, no expressions of regret. Nothing. The system is cold and uncaring. Any victory will feel hollow. Malpractice suit are to be survived, not won.
Mind you, the love of your spouse is not to be dispised. I wouild never have been able to cope with the experience but for the love and support of Olivia, who was always at my side.
But there is also the love of God, whose everlasting arms eternally hold us up, bear our burdens, comfort our afflictions, heal our wounds. In comparisson, all human loves are but shadows and foretastes.
Ultimately, we will find out only vindication through the love of God in Christ Jesus. Whatever is done for Him and His service will receive its reward. It is He who will clear us. He is the only Judge whose sentence matters. It is the ultimate vindication that matters, not the world's judgement.
"Who may ascend the hiull of the Lord?
Who may stand in his holy place?
He who has clean hands and a pure heart, who does not lift up his soul to an idol or swear by what is false.
He will receive blessing from the Lord and vindication from God his Savior."
This is the life to which we are called. I am neither a perfect physician nor a perfect human being. Neither is anybody else. We are all fallible. Sometimes our failings cause harm, sometimes not. But we don't set out deliberately to fail. We do the best we can wth the talents, training, and judgement that God has granted us. If we serve with a willing, obedient heart, we will be vindicated even if, by medical - or the world's - standards, we fail.
Clean hands and a pure heart; a soul unstained by idolotry; personal integrity. No malpractice lawyer in the world can touch these. No storm of life can sweep them away. No judge can rule against them. They are what counts.
He used music to reach me on a different level. I found particular comfort in the works of English composer Ralph Vaughan Williams, a self-described "Christian agnostic" who expressed his questing yet unrealized spirituality in musical terms. His setting of Bunyan's Pilgrim's Progress, and the heavenly vision of the Fifth Symphony, the slow movement of which bore a quotation from Bunyan - "Upon that place there stood a cross, and a little below a sepulcher ... then he said, 'He hath given me rest by His sorrow, and life by His death"' - particularly ministered to my soul. Gerald Finzi's Cello Concerto (written when he learned he had incurable leukemia) and his cantata Intimations of Immortality, Bach's 8-Minor Mass and Edward Elgar's oratorio The Kingdom helped to put my own situation into perspective. I set myself to learn to play Busoni's piano transcription of Bach's Chaconne.
God used long walks in the mountains with our black German Shepherd, Finzi, to remind me that He is the author of creation, and that everything belongs to Him. And He used time, that great healer.
Him. And He used time, that great healer. Some things will never be the same. There will always be a shadow over medical practice, a nagging fear of another lawsuit. Anxiety resurfaces whenever an envelope with a blue and white logo arrives.
On the positive side, Olivia and I are closer than we have ever been - the stress welded us into a tighter team. Our spiritual lives have deepened - we have grown in worship, in Bible study, and in prayer. We have developed a greater desire to perform works of charity, assisting those less fortunate than ourselves - this, combined with Olivia's insight that running could be therapeutic led us to run the 2007 New York Marathon for charity. And we have developed a great appreciation for the manifold blessings of God. As Olivia reminded me during the darkest hours, "Spring will come again." It is a different spring - because God is opening new paths and new opportunities of service ahead for us - but it is truly spring.
David wrote, "Weeping may endure for a night, but joy cometh in the morning" (Ps. 30:5 KJV). And more recently, "The greatest joy and exaltation are born only of suffering," wrote Pope Pius XII, "hence we should rejoice if we partake of the sufferings of Christ, that when His glory shall be revealed we may also be glad with exceeding joy."
By God's grace, they do come again.
Andrew M. Seddon, MD, a native of England, is a staff physician at the Billings Clinic, Billings, Montana. He has published over one hundred articles and short stories, the novels Red Planet Rising, Imperial Legions, and Iron Scepter, and a devotional, Walking With the Celtic Saints. With his wife, Olivia, and black German Shepherd, Finzi, he enjoys hiking, travel, and running. (2009).