How Emotional Responsiveness Transformed My Experience in Medical Litigation

Hello again! How are you? (For real, please feel free to share a comment about what’s new). I didn’t mean to be away as long as I have, but phew, there were a lot of balls in the air? Mostly not bad, but a bit chaotic. Between my husband and I getting back into the rhythm of regular employment, quitting my side hustle, figuring out where my kids are going to school next year (still a work in progress), and volunteering in Minneapolis, writing wasn’t working very well. I didn’t write often and when I did, I’d come back to it a couple days later and not even agree with what I wrote, let alone enjoy it.

As spring is just starting to peek its head out up here in Wisconsin, so is my creative energy, so I hope to be here more reliably again. I have a couple great interviews with Perdita Finn and Lauren Ohayon coming up. I’m learning about the ordination of priests and it is making me more curious about the rituals that initiate doctors into the profession/vocation. I’ve been thinking about creating an herbal apothecary for the most common things I see in urgent care. The plant Angelica will probably be the next one I explore in the Plant Encyclopedia series (and I’m definitely open to requests if there are plants you’d love to know better).

One housekeeping item, between being less able to commit to being here regularly, no longer aspiring to make Substack an income stream, and not really wanting to share your money with Substack for a variety of reasons like their partnership with prediction markets, I have turned off paid subscriptions. If you value what I share here, I’d ask that you pay it forward financially or in whatever way you can to people doing great local ecological work in your area. If you do that, it would mean a lot if you send me a note to let me know. Knowing when I’m having a positive impact definitely puts a little gas in my tank, or perhaps I should say feeds a little extra fiber to my microbiome :) For today, I wanted to share a bit about an experience that has really shaped the last 2.5 years of my life.

As I pulled into the parking lot at my daughter’s elementary school to have lunch with her on her eighth birthday, the phone rang. It was the hospital. They almost never call me on my days off. I picked it up because years ago they had called me to come take over for a physician after an emergency. I was in Minneapolis finishing a final group project for my Masters Degree so I told them I wasn’t available. I later found out that they wanted me to take over because the physician on duty had tried, unsuccessfully, to resuscitate the young son of one of our nurses who had died in a car accident. If I had known the circumstances, I would have gone. I regretted that I hadn’t. So this day, about 11 years later I picked up the phone, figuring I could go help after lunch time.

Immediately, I wished I hadn’t. “Hello Dr. Walsh, I wanted to let you know that the patient’s family has retained counsel to sue.” Whenever I received that information, it would have sucked, but had I let the call go to voicemail, I wouldn’t have been a panicky mess during the birthday lunch. The next several weeks were a blur of basket case. I totally disrupted a weekly online council group I occasionally participated in with my agitated cleaning and pouring out my distress. My level of commitment to persisting in my medical career, already low prior to this information, was non-existent. Aware that I was stressed enough that I might do something rash, I asked for, and was granted a leave of absence (rather than quitting my job straight away).

I spoke with one of the hospital attorneys. The main thing I recall from the conversation was that I should not talk about the case because people I spoke with could be subpoenaed. For me, that was a big blow because talking through things is often how I figure out what I think and feel, work through those thoughts and feelings, and seek reassurance.

After that, it was pretty much a waiting game. I had no idea what, if anything, was happening. I found myself vacillating between imagining worst case scenarios involving decade long legal battles and bankruptcy and counting down the three years after which they would not be able to sue. If I could give feedback to the lawyers and insurers involved in my case, it would be this: It is not compassionate to handle the case without my involvement. I need to know what you are doing, what the most likely outcome is, and what the worst case scenario is. I am thinking about this all too frequently whether you are communicating with me or not, but if you are not communicating, the worst case scenarios I imagine are fantastical.

I want to be clear that while this process was very stressful, I have a lot of compassion and understanding for why this family pursued legal action. Having a disabling illness is far more stressful for them and our merciless society leaves GoFundMe and legal action as the last recourse available to access the care and financial resources needed to manage it.

Another major challenge was trying and failing, to not take the case personally. I didn’t think I tied too much of myself to being “a doctor”, but the threat of getting sued left me feeling not only like a bad doctor, but also like a bad person. As incredibly uncomfortable as wrangling with that was, I think it ultimately did yield some growth for me, as I wrote about a couple months ago. I don’t feel my self-worth is as attached to being a doctor or emergency physician as it was, which is allowing me to pursue my work from a healthier place. I pray that all doctors get to that less attached place, though ideally through gentler means.

Back in October, I received another phone call, this time, that the case had been settled out of court. At that point, I had heard nothing official about the case for over 1.5 years, so it was the end of a painful and distressing limbo, but also the end of the illusion/delusion that I would be able to just let the 3 year clock run out. Because of state laws, I couldn’t reject the settlement even if I had wanted to (I didn’t). While it was a huge relief, the emotions were complex because the case still had to go before the state medical licensing board. I’m not sure it is realistic to expect emotional care and support from your employer, attorneys, and malpractice insurers, but the stark contrast of what came next certainly had me imagining how fairly small changes could have made the process feel very different.

My malpractice insurance included legal representation to the state medical licensing board. Shortly after the case was officially settled, she reached out to me and the hospital attorney. In a 30 minute phone call, she introduced herself and her experience, asked me about what happened in the case, described what the process would be like, described the most likely outcome, and described the worst case scenario outcome. I don’t think she ever explicitly said it, but her manner said, “I’ve got this. You can rely on me.”

This was a very good thing because as far as I can recall, it was the first time in my adult life that I totally cast myself into someone else’s hands. It wasn’t collaborative. We weren’t working together. She was the expert and I was relying on her. At the end of the call, she warned me that it was not unusual for them to take 6 months to make a decision, then asked for my CV to assist her in writing a letter advocating on my behalf.

Reader, this letter was more moving (to me, at least) than I could have imagined a legal document to be. It told the true story of what I did in my career, but made it sound important, valiant, maybe even heroic. Just reading the letter was a moment of tremendous healing.

About 2.5 months after she submitted my records, we found out that the case was resolved with no further action needed. It was such a relief. As wonderful as it was to feel supported at the end of the process, I do think that much of what she did could be easily replicated earlier in the process to make it much less painful. A simple, “We’ve got your back. We’ll be with you every step of the way, “ would have carried me through if it was backed up by actual “back having”. An initial conversation about what that process would be like and a predicted timeline, with updates when those things changed, would have made a world of difference to my active imagination. An acknowledgement that it is a difficult process, that we see what you are carrying and what you have been carrying prior to this would have meant a lot. Recognition of who I am as a whole person, rather than a cog in running the ER machine and a demonstration that who that person is and who she works is valued beyond her ability to keep the machine running might have even been enough to turn a difficult experience into an ultimately positive one. All of these requests cost very little, a small amount of time, empathy, and thoughtfulness. Before, I didn’t know what I needed or how to ask for it. Next time, I will, and hopefully you will too.