Doctors are often seen as a symbol of confidence, certainty, and healing. Naturally, patients expect doctors to cure their diseases and alleviate suffering. Doctors themselves carry the same expectation too. Every consultation, diagnostic procedure, medication, and surgery begins with the single hope that it would make a person’s life better. At any moment, millions of people around the world are subjecting themselves to a doctor with this hope.

Yet like any other field of science, modern medicine is not a perfect foolproof system. It constantly evaluates itself, seeks to improve, changes its opinion, and in the process, sometimes falters. Second, the human body is not the same for everyone. What works perfectly fine for one person may give rise to a serious allergic reaction in another person. Third, diseases also behave unpredictably. Even when a doctor follows accepted guidelines, plans meticulously, and performs a procedure with utmost care, unintended complications or adverse events can still occur. Alternatively, the disease may not follow the expected course of healing and de-route into a downhill pathway.

When such complications happen, the patient and the family suffer the most. They may be subjected to further investigations, additional procedures, extended stay in the hospital, and a consequent increase in the treatment cost. Their despair deserves empathy, counselling and heightened care to tide over the crisis. Nevertheless, there is another rarely understood problem of the emotional burden carried by the treating doctor due to the unintended complication. This is called “second victim phenomenon”.

Medical literature describes healthcare professionals affected psychologically by medical complications as “second victims”.  A doctor’s psychological distress after an unintended adverse event starts immediately with palpitations, sweating, unease, lack of sleep, and a sense of impending doom. This is slowly replaced in the subsequent days by depression, disinterest, lack of appetite, and fatigue. The patient and family’s suffering amplifies the despair of the doctor. During this period, their personal relationship with friends, family and colleagues are also affected. Over a period, the doctor becomes overcautious and hyper-investigatory in his approach to the other patients in an effort to avoid such problems. Repetitive psychological upset over medical complications can lead to a sense of exhaustion, depersonalisation, and under-achievement. This is collectively termed “physician burnout”. Burnout, depression, and fear of adverse events among doctors can affect future decision-making and ultimately influence the healthcare system. Medical sub-specialties prone to unintended complications such as onco-surgery and neurosurgery have been shown to have high burnout.

For doctors, emotional turmoil after an adverse outcome is not a temporary event and often becomes unforgettable. The patient’s name, surgical procedure, the complication and the distress faced by the family are permanently etched in their mind often replaying the disturbing moments periodically. They reiterate every decision, revisit every step, and wonder whether anything could have been done differently to avoid it (though theoretically they know that adverse events are unavoidable).

A complication is not always a mistake from the medical team. A doctor right from his entry into medical education until his last breath aspires that every patient heals well and becomes all right. No doctor intends any harm to fellow human beings. However, many treatments have known risks, often unquantifiable and unpredictable, despite flawless execution. Though these risks are discussed before treatment, it causes unpleasant feelings and distress to both the patient and the doctor. A complication with a 1% incidence for a procedure may happen in the first case or the hundredth patient.

When complications occur despite appropriate treatment, doctors deserve understanding from society and require peer professional support. Supporting doctors after adverse events is not about excusing errors. When genuine mistakes occur, they should be acknowledged, investigated, and used to improve care. The role of mentors and peer support is crucial for handling both the medical and psychological aspect of treating complications. Doctors should cultivate regular hobbies such as reading books, sports and music to distract themselves from troubling moments. Periodic holidays, regular meeting with friends, and conscious involvement in family affairs can help the doctors to reduce the stress of handling complications. Unhealthy ways of de-stressing such as undeterred social media usage, binge watching, alcoholism, substance abuse, and self-medications should be strongly discouraged.

The relationship between doctors and patients works best when built on trust. Patients deserve clear explanations, transparency, and compassion. Simultaneously, doctors deserve fairness and the recognition that medicine can reduce risks but can never eliminate complications and adverse events. Behind every white coat is a human being who celebrates every recovery and quietly carries every loss or unexpected outcomes. A healthcare system that supports both patients and healthcare professionals is ultimately safer, kinder, and beneficial for everyone.

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