I lost a patient under anesthesia today.
I know I did everything right. I was lucky to have a gifted credentialed veterinary technician catch the precipitous drop in heart rate at the end of the procedure. I was lucky that another doctor was nearby, and we could start emergency resuscitation immediately. I was lucky the monitoring equipment was still on the patient, and we had an ECG to show what was going on. I was lucky that my teammates and I had trained and practiced this resuscitation procedure many times before. I was lucky that the owner was available on the phone in just a few minutes and approved continuing CPR. I was lucky that we had already completed the high-risk procedure, and this happened at the very end of the surgery. I was lucky that when I called the owner to let them know I was not successful, I was met with someone who was understanding and appreciative. I was lucky that the owner placed trust in me to do the same high-risk procedure on another one of their pets that same day. And I was lucky that pet did very well with the same anesthesia medications, the same surgical technique, the same veterinary technician, and the same equipment.
Despite all this luck, all these amazing circumstances, and being surrounded by colleagues who are trained, knowledgeable, and ready to go, my heart is a little broken.
If you stay in veterinary medicine long enough, the odds always catch up to you. If 99.9% of patients do great, eventually you’ll do that 10 000th surgery or procedure that doesn’t go well. It is those cases that are the hardest on us. Why that time? Those owners? This animal? What could have been done differently?
The absolute hardest part to accept is that there is nothing you can do to stop this. Sure, you can improve your odds; your surgeries can be successful 99.99% of the time, but then a few decades in, you’ll eventually encounter a case that goes south. You will not remember the 567th surgery you did that was routine and did great, but you will remember the 568th that didn’t make it. Your empathy, your analysis, and your caution will make you a better doctor, but they won’t heal your heart.
Maybe these cases are not meant to be forgotten. Maybe the cases that break us, the ones that are burned in our memories, can be a tool—a way to force us to remember to celebrate the ones that overcame the odds, not the ones that proved statistics right. Today, I was even luckier, not because the first case went poorly but because the second case went well! That immediate reminder of all that we are capable of will not erase the pain, but it brought back an even more powerful emotion: hope. And hope heals heartbreak like nothing else can.