When I look back on the growth that entered my life after an unforeseen adverse patient outcome and medical malpractice lawsuit, I envision myself as a seed. I’m a gardener. Some seeds have tough shells, and cracking those shells can help the seeds germinate. Prior to those hard events, a sturdy shell protected me. The events I’ve described were a hammer. The post-traumatic growth I’ve experienced has been extraordinary, and I’m profoundly grateful for it. That doesn’t erase the fact that it hurts to be hit with a hammer.

Recently, we’ve explored post-traumatic growth -- what it is , 4 signs of its presence , and the surprising first stop along its path.. Today, we turn our attention to Step 2, what Stephen Joseph calls harvesting hope. Before we do, though, I remind you that no compassionate person wishes trauma on anyone. We’d protect one another if we could. Failing that, we do the next best thing by helping each other come out on the other side. 

“Those who try to put their lives back together exactly as they were remain fractured and vulnerable,” teaches Joseph.. “But those who accept the breakage and build themselves anew… open to new ways of living.” Hard events of any kind throw our assumptions into question. Recovery begins with our fragmented ideas and self-concept, what they tell us about the world. Then, if we’re inclined, we start to appreciate, slowly, even subconsciously, our potential to create a new worldview, our new life, taking those fragments as raw material. 

This experience is a human experience, and we are privileged to live a human story. Post-traumatic growth is in our DNA. Will we make room for those genes to express themselves? Let’s explore 3 ways people do it.

1) A Catalyst 

An article in the New York Times explores this subject with the help of Stephanie and Ama Marston, who wrote Type R: Transformative Resilience for Thriving in a Turbulent World. They say that healing often gets underway with the emergence of a catalyst. 

As the journalist, Kristin Wong, puts it, “a fresh perspective… (jump-starts) transformation.” She quotes one of the Marstons: “I don’t think you can force it... a bit of surrender (is) involved... Sometimes it takes days, months, even years to regain clarity,” further adding, “in most cases... the catalyst emerged naturally as the individual accepted the chaos and found strength to regain perspective.”

I get this notion; it aligns with my experience. As I’ve written before, my story took a turn when I encountered a moving essay by Dr. Albert Wu. His description of my experience, published twelve years beforehand, opened doors to self-compassion that I hadn’t anticipated. So profound was the impact on me of that essay that I clearly recall where I was and how I felt when I read it. An honest epiphany. The first of many.

2) Hope Found in Stories

In 2005 and 2010, researchers at Emory University published fascinating evidence that children and teens who could recount their family’s stories handle life’s stresses and moral quandaries with greater equanimity. No doubt the same goes for adults. We need stories.. Be they family, friends, colleagues, or societal figures, we need the stories of those who have survived -- perhaps laughed or prayed or pulled together -- in the face of tough times and gone on to recover and lead wonderful lives. These researchers say to parents: “Bad things happen. Don't pretend they don't. Help your child see that people can overcome obstacles.”

In the midst of litigation, it helped me to recall an experience my father had in the course of his career as a small business owner. Events beyond his control threatened to cast doubt on his very high integrity -- something he valued above nearly all else -- in a community where he had built a business over nearly twenty years. Nothing mattered more to him or was more essential to his success than the power of his good name.

As I confronted my accusers, I revisited those days through new eyes. In my early twenties, when my father hit this bump in the road, I witnessed his enormous stress and prodigious steadiness. When he learned as we all did of this highly disconcerting event via local television, those who knew him longest and best began to telephone our home, one right after another. And I, being in the kitchen that afternoon, took call upon call upon call from one conscientious friend after another simply saying, “Tell your dad I called. Tell him I know who he is. Tell him I’m here for him.” 

As I remembered that time in the midst of my own dark hour, I was reminded that I too would come through. Further, I remembered that there will always be people who know me and what I’m made of, who understand, and who will be here for me. Equally important, I know me and just like my dad, I can be steady, too.

Not everyone’s dad or mom has a story like mine. That’s why it’s crucial that we share the downs of a life in medicine as much as the ups. We need each other’s stories. If you find yourself reeling after an unexpected outcome, maybe even find yourself unable to tell your story yet, consider asking around. Ask someone you trust and admire whether they’ve had an outcome that blew them off course emotionally and spiritually. The more experienced they are, the more likely they will have a meaningful story to share. If the first colleague you ask comes up speechless or empty-handed, try again. And if that doesn’t work, come to me and we’ll talk.

3) Reframing Experience

It’s deeply human to feel ashamed, engage in blame, or both after all kinds of frightening or traumatic experiences. I don’t fully understand why. Don’t know if anyone does. I suspect that it’s a reflex -- something about the interface between the disruptive experience and the human mind. Do we feel shame and blame out of self-protectiveness? Because these hard experiences flag our vulnerability in the world? 

In the event of an adverse patient outcome or malpractice lawsuit, there is often plenty of shame and blame to go around on all sides. No doubt, in many instances but not always, the patient is the one most impacted. Nonetheless, something bad has happened to all concerned, albeit with differing hues and degrees of impact.

A conscientious effort to reframe our experience will serve us. Can we challenge our shattered assumptions? Trade “I’m flawed as a physician,” for, “I’m a human being; there’s nothing my patients need from me more,” say. Or swap “I must be in the wrong profession,” for, “My depth of feeling emerges from deep vocation.” If you find yourself facing self-critical assumptions, give this a try. 

Comment below to let me know what you come up with. I’d love to hear. And join me next time where we’ll continue our pursuit of post-traumatic growth. You and I, we’re worth it!