A Surgeon’s Survivor’s Guilt

My heart tells me I lost them.  My brain tells me I never had them to lose.

One of my mentors has said that all trauma surgeons have their own personal graveyard, filled with patients we couldn’t save, and families’ hearts left broken.  A truer statement has never been said, and this weekend, this trauma surgeon’s graveyard has increased yet again.

The feelings that accompany this increase are always varying and deep.

There is anger.  True wrath.  When the hell are we going to figure this out?  When are we going to stop shooting one another?!  When are we going to learn that drinking and driving can be deadly?!  When are we going to start respecting ourselves, our bodies, and one another?!  When are people going to stop paving a path of destruction for themselves and others that is wide and immeasurable?!

There is sadness.  Sadness over the pain and the fear that my patients surely felt.  Sadness over the waste of life that we witness.  Sadness for the families left behind, in a new world they never anticipated.

And yes, guilt.  Guilt over being able to go home, when our patient couldn’t.  Guilt for leaving the hospital to enjoy my family knowing another family has just been destroyed.

This weekend was a particularly rough one for myself, and the hospital at which I work.  Although to most people around the country, it was just another act of violence, to myself and our community, it was felt deeply.  Every person in our hospital was stung, upset, and shocked.  Everyone knew what happened – I received touches on the arm, knowing hugs, and reassuring smiles.  They knew I did everything humanly possible even when the inhuman was needed, but that knowledge is a poor salve against this type of wound.

So please, if you know someone who works in healthcare – give them a hug, a high five, or even a thank you.  I have said before how we all take you, our patients and communities, home with us at night, but please also know that our lives are never the same either.  Every patient encounter alters us – sometimes subtly, and sometimes drastically.  We are changed, and we never forget.

Stay safe.

20 thoughts on “A Surgeon’s Survivor’s Guilt

  1. Breakdown of the family. We had cops who specialize in gangs. The gang has replaced the family. This is what you are seeing.

    I would also take the chance to support that you hug and love on your own families. This is how its stopped: one family at a time saying I love you, care about you and you are worth my time.

    Btw, meth is also an issue, I know you indirectly addressed it, but drugs that are coming out now are quite potent. I know its not gunshots and the like, but drugs and territories fuel a lot of this.

  2. My heart and my thoughts are with everyone in your hospital. We had just about an exact same instance in my current community here in Colorado with a deputy sheriff and a man strung out on meth. They even put our hospital on lockdown and I was in the ED at the time he was brought in. Very scary stuff, but your talent and your brilliance is what saves many other lives. God decided it was time for Deputy Koontz to come home and everyone– his family included, knows whole heartedly that you did everything you could to save him. I will pray for you and I hope you can find some healing in this and be able to move on in your career doing just that– your absolute best (that you know you do 150% of the time).

    • Very well said!!! These surgeons feel these feelings on every surgery not just traumas. I had hernia repair and have had a couple issues. My surgeon expressed how sorry she was and that it must be her fault…it is not her fault, things happen. Give your surgeon a hug, smile, a kind word or jesture. It might just be the one thing the genuinely needed to make a difference in their day/life.

    • cfranklin87…. Would you permit me to challenge one of the statements in your otherwise gracious comment? Even if you disagree, I’d ask you to give some moments to consider something. One of the quickest ways to turn a child’s (or spouse’s or sibling’s or surgeon’s) heart away from or against God is to suggest (incorrectly, I believe) that “God needed another angel” or “God needed him/her more than you did” or that “God took him home.” As a hospital chaplain, I hear these statements all too often, but – as a chaplain – it is not my place to correct or challenge such statements. However, in this context, permit me to say that I don’t embrace this view of God and how God engages in our world. Active God is, but also active is each of us, like the shooter who ended a life. Sadly but truly, God’s will is not the only will that’s done on earth. Death has been defeated, but death is still the enemy. We live in a broken world that is yet to fully experience God’s full re-creation, reconciliation and redemption. Until that time brokenness, and death, will remain our lot. As I said, you might not agree, but I wanted to provide a different grid through which to look at this tragedy.

      • I am so sorry it’s taken me over 3 years to reply. Needless to say I have suffered great loss and extreme depression. Since then, I have survived two suicide attempts and many almost attempts. But I went back to the comment I left and read it through again. When I said that God thought it was Deputy Koontz’s time to “come home” I did not inherently mean that God caused the act in and of Himself. No, God does not inflict this kind of torment on anyone, nor their families. You’re right, that this was purely an act of the enemy. What I meant, was, in the critical hour of Deputy Koontz laying at the veil between this life and the other side, God had to re-evaluate the situation. Perhaps he was going to have such irreparable damage, that bringing him into the kingdom was the better decision. As a hospital chaplain, surely you’ve dispensed precisely that advice to hurting patients. That is all I meant. I apologize if my comment caused confusion about God’s intentions– I hope I’ve cleared up your confusion, though surely after 3 years you’d forgotten. Bless you for the work you do and Michele, as well. You both provide equally valuable and important services to the people of this world and I defer to you both for your skills and wisdoms. 🙂

  3. Thank you for writing this! I’m one of the PAs from Howard ER and it’s been a rough few days for our department. This article couldn’t be more perfect. Thanks for doing what you do. I hope to one day work in a trauma center, and I look forward to following your blog. Prayers to you and your team.

  4. So true!! Well said Sir!! I worked OR & trauma. We do take our patients home at night. We wonder why. But, never get an we answer.
    All we can do is our best. And most of all pray!
    Pray for peace , pray for their souls. Pray they have peace for a job well done. We can’t do much more, than support each other in these tragic times. You did the best you could do. We cannot ask for more. God was with you then.🙏😭❤️🙏

  5. Thank you for the work you do everyday… not only on the LEO’s but everyone. Big hug for the ultra-strong and super caring doctors you are !! Please give hugs of support to the whole team as well! Your community loves the work you do… just not always an avenue to show it!

  6. Doc,

    We see you, too. We know this isn’t easy for you. We know this one will bother you and it will carry over until your next case. And just like our husbands have to do- you will compartmentalize your emotion so you can focus on your next case- the next person who needs you. But know this- if it were my husband, and God forbid one day it is, know that it is the surgeon just like you who will be haunted by a poor outcome taking care of him- not because we want you sad, because we need you fighting like hell for him. It’s your skill that makes you an accomplished surgeon, your humanity that makes you who I want operating on my family member.

    I’m sorry about your patient. I’m sorry for all of us.

    • My husband has nothing but good things to say about the trauma surgeons there. His SWAT team even works with a couple of them directly. They do absolutely everything they can do!

  7. The lose and heart break is felt miles away as well. I didn’t know Deputy Koontz or his family but I was deeply affected by his loss. I pray for everyone that was touched by this loss. You did all you could to save a life someone else decided to take I’m sure his family is grateful that even though you couldn’t you did your best.

  8. I have nothing more to say other than Thank you for all you do. Thank you for consistently dropping whatever is going on, whether it be office notes or outings with your family, to literally RUN to save us all. May God bless you.

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  10. Thank you for sharing this piece of your world. As an LEO wife, EMT, mother, and many other hat-wearing gigs, I want to say thank you first. Also though, I hope you know it’s ok to grieve for the loss in your own heart. That in itself was something I personally had issues grasping for so long. It was if I felt I had no right to focus inward when others were so obviously torn apart. It sounds like this piece is a part of that process for you. I’m glad! We, the whole community, know we may need you at any time for ourselves or a loved one. Honestly, not once has my confidence in your abilities faltered. While you may not share my beliefs, I did lift you up in prayer just now too. I’m sorry for your losses, yet oh so thankful you come back each shift!

  11. To the doctor who wrote this article: Know that you are not alone in your feelings. I grieve for the wife and other family members who have lost their loved one. And for the little baby who will grow up without a father. My prayer is that God will give to you the comfort, peace and strength to help you get through this as well as them. God Bless You, Doc!!!!!!

  12. Thank you. As a former EMT, I have been there. I used to deliver people to trauma surgeons, albeit sometimes indirectly. Because of one of those galvanizing community events, we teach people how to release that trauma from their bodies.

    Because we are changed. We can’t forget. But we don’t have to be haunted.

  13. Thank you for all that you did for Deputy Koontz. We all know you gave it your all and I am thankful that he had a bright compassionate surgeon and team by his side. God be with you as you continue to use your skills.

    Tasha Campbell
    ISP wife, mother x 3, and RN

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