(Respecting the concerns of legal and insurance counsel, we can talk about our feelings with trusted confidants but not the specifics of the case.)
Lawsuits markedly affect our most intimate relationships, especially our marriage. Our first decision is whether we are going to share that we have been sued with our spouse or our closest intimate, a decision that sets the stage for our emotional life during our long passage through the lawsuit. What we choose to do, of course, is a function of the strength of our relationships as well as of our personality style. Most of us choose what, for various reasons, suits us even though this choice will influence and perhaps alter our life dramatically.
Ideally, we find our richest source of support in our spouses or others close to us. We share our innermost feelings with our closest confidant and feel not only understood but also cherished by their responses. They may not always appreciate our obsessions about the medical details, but they do know how deeply we feel for the affected patient and family and sense and understand the emotional costs of being charged with negligence.
Only our spouse knows the dedication we feel or how hard we work to maintain our competence. They reinforce daily our own efforts to reassure ourselves that we are good physicians. Empathic spouses not only absorb our irritability but also share our worrisome nighttime vigils while maintaining a daytime calm in our family life, shielding us from unreasonable demands, and managing our social life. Supportive spouses understand rather than resent the time preempted from leisure and family activities by the multifaceted obligations of defending ourselves legally. We may be too preoccupied at the time to notice the generosity and graciousness with which they support us and maintain a balanced environment around us.
Spouses reveal their dedication when they actively join themselves to our battle to defend our integrity and honor. A dermatologist's wife describes becoming almost an expert in malignant melanoma, the clinical focus of her husband's lawsuit. She searched the literature, developed summaries for the defense team, attended depositions, and, at the time of trial, filled the courtroom with a supportive group of family and friends. The message to the jury that eventually acquitted her husband was of how highly he was esteemed by his colleagues and his community.
Not everyone is so fortunate. Some physicians characteristically keep work issues to themselves, not wanting to bother their spouses by making them privy to such concerns. When they are sued, they may be too ashamed or traumatized to share their deep feelings about their work with their spouses if they have never done it before. The stories of those physicians who choose to handle the situation on their own and muffle their suffering, as they habitually do, in silence, overwhelm their ability to tell them or to recount their side effects. This falsely shrouded suffering can manifest itself in an array of behaviors and symptoms that, easily misinterpreted by even those close to them, undercut them and complicate their lives. How are spouses to understand when their physician spouses, usually as in control of their world and in command of their feelings as a Gary Cooper cowboy hero, become increasingly preoccupied and irritable, replacing any interest in sexual or romantic life with growling ruminations on sleepless nights, seeming to become different persons supplanting their interest in their families with their absorption with a secret they hesitate to share-that they are being sued for malpractice?
Spouses cannot miss our backing away into emotional distance, our spending
ever more time at work, and our coming home, persons cut off seeking solitary rest. Such combustible scenarios flare up easily into misunderstandings, accusations, and even bitter arguments. Such a wartime atmosphere can endure for months and sometimes years. It is not uncommon for spouses to feel so shut out of intimacy with us that they suspect that we are involved with another person. The possibilities of unnecessary pain and even separation are high unless we reject passivity and fully incorporate our poorly informed but long-suffering and frustrated spouses into full partnership with us in suffering the trauma of being accused of negligence.
It is possible that after sharing our distress about the lawsuit, we are disappointed in our spouse's lack of understanding and inability to offer us support. Just as we need our spouses to understand how preoccupied we are and how unhappy we feel, so they need us to understand and appreciate their bewilderment and the world they are trying to hold together. To secure the objective of protecting and strengthening our marriage during the sometimes protracted siege of malpractice litigation, we must recognize just how hard and how patiently we must work together to enlarge our mutual understanding.
Adapted from “Adverse Events, Stress, and Litigation: A Physician’s Guide” by SC Charles and PR Frisch, with permission.