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It finally happened to me: I was sued for malpractice by the family of a patient who had died suddenly. My inner turmoil in the aftermath of this traumatic event.
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A large part of my grief was, of course, for the untimely death of my patient and the horrible loss his wife and children suffered. At the same time, I admit that a lot of my mourning was actually for myself: I knew it would never be the same again. I found myself waking up many times at night from fitful sleep; I was not finding pleasure in the usual joys of life. One thought was overwhelming all others: Only when the malpractice claim was settled outside of court was I able to diagnose myself as suffering from posttraumatic stress disorder: I eventually realized that suppressing and denying these symptoms was undermining my emotional resilience, and I sought professional support.

I always teach interns that good communication with patients is not just a matter of politeness or an expression of our common humanity; it also helps inform the diagnosis and prevents harm by reducing unnecessary tests and potentially dangerous procedures.

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Now I add to my regular speech, with a sigh, that it helps enhance trust between the doctor and the patient and reduces the chances of prosecution for malpractice. I know I started down that path after the prosecution. When I reflect on my work since the prosecution, however, I see that defensiveness made me a bad doctor. Michal enters my office. She is 45, and over the past few months she has visited the emergency room dozens of times.

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She has attacks of heart palpitations, a sense of choking, tingling in the hands, shortness of breath, and dizziness. She has already completed a stress test, spirometry, and gastroscopy. A cardiologist referred her for echocardiography and Holter monitoring, and during one of her hospitalizations she underwent a catheterization that found small-vessel disease.

The gastroenterologist diagnosed gastroesophageal reflux, prescribed omeprazole, and referred her for an abdominal CT, which showed an unclear finding in the adrenal gland and a fatty liver. She now has appointments for annual follow-up CTs, an appointment at a liver clinic, appointments for meetings with a cardiologist and a neurologist, and an appointment for vestibular tests.

But I know what she is suffering from.

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The description she gave at her very first visit matched the diagnosis of panic disorder, a condition I know how to treat quite successfully. It is quite likely that if you take this medication, the symptoms will either subside or at least be significantly reduced.

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After all, her father has heart problems, and her neighbor who complained of dizziness eventually discovered she had a brain tumor…. She notes that perhaps she should add to the long list of tests Michal has already had. She should add a lumbar puncture, a bone marrow biopsy, and an MRI of the brain and cervical spine.


The postprosecution Dr Kannai cannot allow herself to leave any stone unturned, even though she is an experienced clinician who has known Michal and her family for over 20 years. She knows that a true family doctor would now take the time to encourage, give strength, and offer treatment. Get fast, free shipping with Amazon Prime.

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