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Doctors are trained to treat medical emergencies such
as a cardiac arrest, intraoperative bleeding, or an
asthmatic in acute respiratory distress, which means
they are used to handling a crisis . These are life-or-death
crises, and doctors are expected to retain their cool
and remain unflappable, because their presence of mind
can spell the difference between life and death for
their patient.
However, these are crises which affect other people
– your patients ! Handling a crisis in your personal
life is often a completely different cup of tea, and
many doctors go to pieces when faced by a personal crisis.
The truth is that all of us face crises in our lives
– but thankfully, not too often ! A personal crisis
is as old as mankind , and divorce, financial loss,
being sued for malpractise, illness and bereavement
are some of the things in your life that can bring you
to crisis point.
By the law of averages, it’s simply a matter of
time till you are hit by your first crisis. The older
you grow, the greater the chances of facing a crisis
– and the sooner you learn to cope with them,
the better ! This is why self-made individuals who have
come up from scratch often end up doing so much better
than others in life. They have faced many crises in
their life before, and have successful dealt with them.
Each crisis you handle makes you stronger, and more
capable of handling the next crisis as well ! It’s
also much easier to learn from other’s problems
, which is why it’s such a good idea to help others
( juniors and colleagues) to cope with their crises.
Your objective advise can help them deal with their
problems– and will also teach you what to do when
you face similar problems in your own life !
Adversity is the best teacher , and a crisis can teach
you a lot about life and how to live – the key
question is - how well can you learn ? Accept that the
crisis will change you – hopefully for the better
! Living through a crisis can be hell – but you
need to learn to maintain your equanimity . Don’t
take out your anger and rage on your employees, patients,
colleagues, friends or children. Trust your inner strength
– you have been through worse, and you can weather
this storm as well ! There are certain personal qualities
will help you cope better and these include: self-confidence;
optimism; a sense of humor; resilience; and faith in
God. ( Interestingly, playing games such as chess or
tennis will help you deal better with a real life crisis
when it hits. Being 0-5 down in a tennis match or facing
a check is a crisis of sorts, and dealing successfully
with this mini-crisis will help you deal with the bigger
real-life crises , when these arise.)
Unfortunately, when faced with a crisis, many doctors
start feeling sorry for themselves; start blaming others
for their predicament; or waste energy looking for a
scapegoat. You need to move beyond self-blame –
don’t react like a victim. When a marriage crumbles,
a job is lost, a loved one dies or a child suffers a
debilitating illness, people tend to blame themselves-"If
only I had worked harder," or "If only I had
taken better care of him." None of us gets through
life without some mistakes. You may share some of the
responsibility for the crisis, or, more likely, it would
have happened no matter what you did. Either way, the
important thing is what you do with the rest of your
life. When recovering from a life crisis, self-blame
is a luxury you can't afford. This is pointless and
an exercise in futility - it’s better to deal
with the crisis and move on !
You may believe it is impossible for you to recover
from this hard time; and sometimes a second crisis comes
and sets you back before you recover from the first
crisis. Everyone has their own level of being able to
cope before they reach their breaking point. High adrenaline
levels will help you manage the initial crisis; but
persistently elevated levels can be counterproductive
! You may find that the stress of coping will start
affecting other parts of your life such as your concentration,
sleep, appetite and sexual life. You will find your
feelings swinging wildly from hope ( that the crisis
will blow over) to fear ( that the worst will come to
pass) , and this can affect your mental and physical
health. The crisis needs to be acknowledged and dealt
with - you need a chance to adjust and start the healing.
Please reach out for help –you will soon find
out who your real friends are in your time of need !
Don’t let what you are going through embitter
you. For example, one of the commonest crises a doctor
will face is being sued for malpractise. Many doctors
become cynical and disillusioned once they have been
sued, and start treating all patients as potential adversaries.
Don’t let one isolated incident jaundice your
view on life – you need to bounce back and move
on !
It’s interesting that the Chinese expression for
“crisis” consists of two characters - one
means “danger” and the other “opportunity.”
Every crisis carries its own blessing with it –
but often only the passage of time and a lot of maturity
will allow you to find the good side in this mess. People
seldom tap into their deepest strengths and abilities
until forced to do so by a major crisis. Living through
a crisis will definitely make you more empathetic towards
other people who also find themselves in a crisis –
such as your patients. Many doctors find they are much
more sympathetic towards their patients when they have
faced a critical illness themselves !
One of the best ways of learning how to cope with a
crisis is from our patients . Compared to most of our
personal crises, our patients go through much worse
situations, such as the loss of a child, life threatening
illnesses, and imminent death. Many will deal with such
a crisis with such grace and wisdom, that they are living
lessons for all of us. Their attitude can be a source
of inspiration and courage for you.
It’s important to keep your perspective –
be objective. You will have to accept that life is not
always fair, and that “bad things do happen to
good people” because “ we live in an imperfect
world." A sense of humour can be invaluable at
this time ! No personal crisis ever marks the end of
the world, even if it seems to do so at that time. Don’t
magnify the problem or start imagining that it is unmanageable.
Also you need to learn to be detached - don’t
take it personally. Many people have been through worse,
and have survived their baptism by fire , and so can
you ! Keep your self-esteem intact – this will
help you to bounce back. Learn to accept reality, no
matter how bitter it may be, because the sooner you
do this, the easier it is to deal with it. As Rudyard
Kipling advises so wisely and eloquently in his poem,
If, “ If you can meet with Triumph and Disaster,
And treat those two impostors just the same”.
Research has shown that when faced with the same crisis,
some people will crumble; other will survive; while
others will thrive. These are the hallmarks of the survivors
.
Reason : Survivors focus on problem-solving their crisis.
They control their emotions; set aside panic and think
logically during a crisis, especially about the true
nature of the crisis and realistic options for solving
it. They always have a Plan B, in case things don’t
work out as expected.
Focus : Survivors are 100 percent present in the moment.
Thinking too much about past experiences or future possibilities
distracts from survival.
Integration : Survivors must be emotionally healthy
enough to integrate their tragedy and its consequences
into being one part of their larger life story.
Positivity: After a crisis, you will never be the same
again. Making lemonade from lemons is crucial after
a crisis. The key challenge is, how can you make something
positive of this? How can you come out of this a better
person?
While some crises can blow over quickly, others can
be a long drawn out and painful process. Not only does
it eat into your time, it also saps your energy and
monopolizes your attention. It also extracts a huge
emotional toll, and many doctors when faced with a crisis
go through a process of five classic phases of grieving,
as first described by Elizabeth Kubler-Ross when talking
about dying patients. The first response is one of Denial:
I am a fine doctor and a good human being ; this can't
be happening to me! The next stage is one of Anger:
Why should this be happening to me when I am such a
good person? Doctors will often vent their anger on
family-members, their staff, and even other patients.
The next stage is one of Bargaining, where the doctor
pleads with God to, 'let him off the hook this time,'
and promises never to err again! This is followed by
Depression. Many doctors start doubting their competence
and professional ability, and wonder if they should
just stop practicing medicine altogether. The final
stage is one of Acceptance, when the doctor comes to
terms with the fact that dealing with a crisis is simply
a fact of life everyone has to face up to; that it is
not a reflection on his personal worth, and learns to
get on with his life! Being prepared for the emotional
havoc which going through a crisis can play with your
life can help you to cope better: don't try to minimize
the impact it has on you and your feelings by pretending
it's of no consequence!
It’s usually a good idea to continue working,
if you can do so. Your patients can be a source of strength
, and if you find satisfaction in taking good care of
them, this will help to bolster your self-esteem and
confidence ! Hiding and running away from the problem
will often compound it.
It’s a good idea to prepare for those crises which
you can. Some are predictable, and you need to manage
these proactively. For most doctors today, it’s
simply a matter of time till a patient sues you for
alleged malpractise. Taking out a professional indemnity
insurance policy and knowing what to do when you are
sued will help you retain control. Be prepared –
have a plan, and then follow it.
A key part of handling a crisis is damage control, and
there is often a lot you can do to prevent the matter
from becoming worse. It is natural to feel like a helpless
victim after a devastating crisis, but you can't recover
from grief until you overcome these feelings. In the
midst of your sorrow, make a plan to take charge of
your life. While you may not be able to solve the whole
problem or wish it away, remember that no matter how
much of our life we think we cannot change, there is
always that part that is within our control, and that
we can work on – be it 2 percent, 5 percent, or
whatever - it is always more than we suppose !
Going through a crisis often serves as a wake-up call,
which forces you to look at the “big picture”
and where you are heading in life. Treat this crisis
as an educational lesson – it may prove to be
an expensive lesson, but you need to learn it ! Many
of us get so desensitized by the daily monotony of life,
that we often lose our ideals and goals. A crisis will
help you focus on the purpose and meaning of your life;
so that it can actually serve as an opportunity for
personal and professional growth. Life is full of ups
and downs, but the sad reality is that we all learn
much more from the downs !
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