Is showing emotion a sign of guilt?

Mary - posted on 06/20/2010 ( 18 moms have responded )

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A friend of my sister's had a baby at my hospital a few weeks ago. It was a much desired pregnancy (they had been trying for several years). Although in her late 30's, she had no other risk factors or complications. She was induced at 41 1/7 because the routine ultrasound done for being past 40 weeks revealed a low AFI (amniotic fluid volume). Her induction went smoothly, although slowly. After 17 hours, a decision was made to do a c/section for failure to progress. (She's a tiny girl, not even 5 feet tall, so it wasn't a huge surprise). Throughout labor, the fetal heart rate was reassuring, without any indications of distress, and the amniotic fluid was clear.

It was, therefore, a HUGE shock to everyone in the OR when this baby came out and would not breathe. Nothing, nada...even after preliminary resuscitation measures were initiated. It's not entirely uncommon for some babies to need a little "jump start" to breathe, but the vast majority of them respond within the first minute or so to wither stimulation or a little bagging. This baby had absolutely NO inspiratory effort whatsoever. He was quickly intubated, and in the NICU, where he did begin to perk up within the first hour or so. Because of concerns about what underlying issues there may be, as well as the neonatologist's opinion that he might benefit from a specific treatment, he was transferred the the NICU at Johns Hopkins.

The OB caring for this couple is one of the most brilliant, caring women I know. It's not just how incredibly smart she is, but she posesses an intuition about her patients that is truly rare, and always dead on. I trust her judgement implicitly, and have complete faith that there was no way she could have predicted or anticipated this outcome. She was absolutely shocked when this kid came out the way he did.

She is also a remarkably kind and compassionate woman, and the mother of two boys whom she loves beyond measure. She truly cares about each and every patient and baby she delivers. I have watched her sit and cry her heart out with patients who have a loss, and cry with joy when that same patient later has a healthy baby. Words cannot convey how highly I, and everyone who has ever worked with her, thinks of her.

Therefore, it was no surprise to me when she spoke with this couple after the delivery about their baby, and the seriousness of his condition, that she cried with them at the beside, and shared in their fear and concern.

What did shock me was hearing from my sister about how other friends, upon hearing the story of this birth, jumped immediately to the conclusion that this doctor was crying out of guilt, and that she somehow "missed something" which was why this baby was so sick and unstable. Her one friend contacted me, and went off about how horrible this doctor must be to have let her friend go past her due date, and how she should have just sectioned her from the get-go because of her petite size. She said "Well, I heard that doctor was crying when she talked to them....must be she feels guilting for causing their baby to have all these problems....she was probably crying because she's scared, and she knows that she's going to get sued, and stopped from hurting anymore babies."

I was floored. Just because a doctor was upset, and empathetic to her patient's situation, many, many people interpreted it to mean something else! Is that really how people think?

Despite the fact that it has now been determined that this child has a congential heart condition that is NOT something that could have been diagnosed prenatally, my sister says that many of their mutual friends keep talking about how this couple should sue, and it must be the OB's fault.

Is this really how the general public views their care providers? Are they always responsible for an unexpected bad outcome? Is showing emotion somehow conveying a sense of guilt, rather than simple human compassion?

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I don't think the doctor feels guilty sometimes bad things happen and nobody can foresee them. Human compassion is great however, I would feel really uncomfortable with any doctor I was having to see displaying these kind of emotions in front of me because I look to my doctors to support me in a professional way with compassion but still professional (no crying) - they are there to support me not the other way around (maybe thats the Brit in me stiff upper lip and all gqtm).

Jackie - posted on 06/23/2010

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People are always looking to place blame on somebody for unfortunate situations. People are very irrashional (?) when they're hurt or in dispair.

[deleted account]

What a lovely, empathic doctor. Showing emotion is certainly NOT a sign of guilt!
I hope everything turns out for your friends and their little boy!

Shelley - posted on 06/21/2010

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No!
Emotion is natural and normal we unfortunately don't know why some of our little babies go so soon i am so sorry to hear about this. Nothing will bring this baby back and suing and seeking revenge will not cause anyhing but more hurt and grief.
Society does seem to always want someone else to pay this is so sad.

Mary - posted on 06/21/2010

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Christina, you are partially right about size. Height has nothing to do with it, but the size of your pelvis does. There is usually a correlation between foot size and pelvis size, believe it or not. I personally have found that if a woman wears a shoe size less than a US 6, she is much more likely to end up with a section for failure to progress or descend if that baby is over 6lbs. (I'm only 5'2", but wear a size 9 shoe - my daughter pracitcally fell out of me!) As I said, she got more than a fair shot at a vaginal delivery - much more with this practice than most doc's would have given her. At the time, these same friends were thrilled that they let her go past her due date, and labor. It's just that now, they have become Monday Morning quarterbacks, who are bitching about everything in hindsight.

C. - posted on 06/21/2010

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First of all, petite size has NOTHING to do with whether or not you can vaginally deliver a baby! A friend of mine had a baby recently.. Not much taller than the woman you are speaking of in the OP and she delivered her baby vaginally! A 7 pounder! MY FRIEND IS TINY!!!!



Second of all, I am shocked that people would actually think that about a doctor that has given no indications of any wrongdoing. That's wrong, IMO.. I've always wanted to have nurses/doctors that were empathetic b/c sometimes it's nice to have that extra shoulder to cry on, you know? I can't believe people would say that! I would much rather have your friend as my nurse than some of the coldhearted nurses I've encountered before.

Ez - posted on 06/20/2010

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I bet that if this woman had been taken for a scheduled c-section at 38 weeks, and something had gone wrong then, these same people would have been screaming that the OB took the baby too early and should have let the pregnancy come to a natural end with spontaneous labour. Or if this OB didn't show emotion, they would be claiming she didn't care and was neglecting her patient. Some people just can't help but whinge and complain. I had a patient threatening to sue one of my doctors (I'm a medical receptionist in a GP office) just last week because she thinks he misdiagnosed her gall stones 18 months ago!!!

I actually think grieving parents can be excused for lashing out and trying to pin the blame on someone in the short-term. I imagine it's a natural response to an unexpected shock and the confusion that must follow. But for outsiders to be stirring the pot like this is wrong. They should be focusing their efforts on supporting this new family, instead of creating more drama.

*Lisa* - posted on 06/20/2010

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I agree it's our human nature to blame someone, find a cause for the circumstance and then sue the heck out of it.
I also got emotional reading the story, which obviously was not out of guilt. I think it's pretty harsh that her friends jumped to that conclusion, but maybe they were just trying to make her feel better, validated, justified, something other than pain or fear of what could happen to the baby.
The OB sounds lovely and any woman would be lucky to deal with her.

Mary - posted on 06/20/2010

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Krista, you are right...we all look for a cause or reason when something goes wrong. This is especially true in obstetrics. Everyone envisions and expects the perfect baby. In this day and age of extensive prenatal testing, it seems to really thow everyone for a loop when a baby is born with issues that were not known prior to birth. Trust me, it shakes all of us to the core when something happens like the delivery I'm referring to. The nurses who were in that OR are still upset about that baby...and check on his status every shift they work (and hound me for updates as well!).

15 years in OB has also taught me that many, many parents cannot accept that some things are truly just acts of nature, and were not caused by someone, or something. There is an incredible need to hold someone accountable, and make them pay....even if there is no clear case for fault. For example, most cases of cerebal palsy are NOT the result of trauma during labor or birth...they most likely occurred at some earlier time in the pregnancy. And yet, most of these parents sue (and win), despite there being any clear evidence of negligence or malpractice...and numerous expert testimonies that the standards of care were met.

I guess I was just shocked, appalled, and saddened that some many intelligent, educated, and normally reasonable people would automatically assume that the doctor MUST have done something to cause this child's condition - and that her distress was an "obvious" sign of her guilt. I was also a bit hurt....as an L&D nurse. While it is my job, it's a little different from some other occupations. I can honestly say that ALL of the people I work with - nurses, docs, techs, clerks - we all really do CARE about these woman and there babies. We are heartbroken when a mother loses her pregnancy, and cry with them, and for them. I often am moved to tears of joy watching a new parent hold their baby for the first time - and most of my coworkers are the same. I find that I am evem more emotionally involved since giving birth to a child of my own. I never even considered that diplaying such emotion could be construed by others as a sign of guilt or wrong-doing.

I should add that, to the best of my knowledge, this is NOT the mindset of the parents of this baby. They are completely focused on the progress and well-being of their son, and seem to understand that this was an unpredictible, and unpreventable act of nature. It is simply how his heart was formed. At present, it is not clear what the long-term prognosis is, but he will most likely need a heart transplant at some point in the future.

Charlie - posted on 06/20/2010

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Even i nearly cried just reading that !!

Youd be a pretty hard type of person to NOT be upset by those situations , i know i would be crying .

Krista - posted on 06/20/2010

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Unfortunately, when something like that goes wrong, our first instinct is often to ask "why?" When bad things happen to us, we want to find a cause, a reason, someone to blame. Because otherwise, the alternative is to realize that sometimes, shit just happens. And there's not a damn thing you can do to prevent it. And that is just way too scary for most of us to handle. And it was way too scary for that couple to handle.



So, you combine that, with the fact that stereotypically, a doctor exhibits no more emotion than their professional "concerned" face, and you have a desperate set of parents grasping at any straw they can, to find SOMETHING upon which to blame their current troubles.



That's my armchair psychoanalysis of the situation, anyway.

Elisabeth - posted on 06/20/2010

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I've never thought like that. I'll tell you one thing, whilst reading this story, I got a lump in my throat. I always do when ever I read/hear about a baby or child in a bad situation. If I hear of a baby being born sleeping or passing on shortly after birth my tears will be flowing, even if I never met the parents or know nothing of them. Is it guilt? No it's a response that comes from me without my permission, I can't help it. I can't even discribe it or why it happens, maybe because I am a mother and it is showing my own fear of losing my children, maybe it's because it's just plain the saddest thing in the whole world.
Was the friend a parent?

Suzette - posted on 06/20/2010

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I believe there are good people in the world, while they may be few and far between, and they do exist in the medical profession as well. I had to have a crapton of dental work done a while back, severe dental work. It was done for free through an organization and I saw an oral surgeon that was amazing. At the end of the process he actually told me that if I ever needed anything done in the future that all I needed to do was call him and he'd make sure to put me on his calendar and get it done, for free. Not for a discount, but for free. He was amazing through the entire process, he made sure that my fears of dentists were calmed, I was completely numb and asleep and taken care of so I didn't freak out. The one time I did wake up before I should've, he calmed me down (I was screaming at the end of surgery, I believe I'd had a nightmare). He is one of the most compassionate people I've ever met, in all the medical fields actually.

I don't believe he felt guilty at all, empathetic toward my situation? You bet!

ME - posted on 06/20/2010

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When I told my doctor that my husband had lost his job 6 mos into my pregnancy with Mayah and, therefore, also lost my health insurance. She was very compassionate, when I came back the following week and told her that Travis was being tested for testicular cancer due to a recent development, and that we had no ins. to pay for his tests or my care, she cried with me. She promised to see me for free, and to care for me and my unborn baby until I delivered at no charge. I am certain that she wasn't feeling guilty, and yet she showed emotions. Every human being has the capacity for compassion. Just because a person is a medical professional or a scientist doesn't mean they have lost their "heart"...I can't believe people would jump to such conclusions! Are "we" really that cynical? How sad!

Rosie - posted on 06/20/2010

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i think doctors have it very hard. if they get too involved and emotional it can make their job VERY difficult to handle. they have to act like emotionless robots or else they would go nuts, IMO.


there are those doctors that have the ability to be compassionate, and show emotion without it affecting them personally, and i admire them. that is the kind of doctor i would want to have. i don't think there are too many of them out there though unfortunately.

i do not think her emotions showed guilt at all. i think it showed empathy, frustration at what is not a perfect science, and simple human feelings. those people should be ashamed if they are thinking anything else.

Sara - posted on 06/20/2010

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I think it has nothing to do with guilt at all. I think it has everything to do with what a doctor should be, which is a feeling, empathetic person who can relate to their patients. I think some people might be taken aback when doctors react that way simply because most doctors have the bedside manners of toads and mistake that for a sign of weakness. And perhaps why most doctors don't show this side of themselves is precisely because they are afraid of being sued. I think your friend's friends should be ashamed of themselves for suggesting that.

Sorry to hear about your friend's baby...hope everything turns out ok.

Joanna - posted on 06/20/2010

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Maybe it just depends on the area a person is in. When I lived in North Dakota, all the doctors were extremely compassionate and caring. Here in Orange County, CA, it's a doctor's job to get the job done and show little emotion. So perhaps those friends were raised in the California mindset... they got the job done, if they show emotion then they are weak or did something wrong. I hate that mindset, but that's kind of how it is in a lot of places. You trust them to do their job, and you rely on family/friends for emotional support, not your doctors.

Carolee - posted on 06/20/2010

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That's horrible that the "friends" would automatically jump to that conclusion! Not everything shows up on the ultrasounds, and surprises (good and bad) DO happen. I would be thrilled if my doctor showed that much compassion. I actually chose the hospital that I did (I'm going to give birth in a couple of weeks) because the nurses are almost all like this doctor. There are no guarantees in pregnancy or parenthood in general... especially with health issues.

Yes, I would be devistated if something like this ever happened to my kids. But I would have the common sense to know that it isn't the doctor's fault... and, around here, 42 weeks is the longest they will let you go before inducing.

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