When I was in medical school, a friend of mine asked me if I saw any ghosts in the hospital. No. I don't believe in ghosts. "It seems to me that doctors are always haunted by so many ghosts." I thought my friend was so very quirky, but she was so very correct. We are all haunted by ghosts.
My first ghost was a wonderful elderly lady s/p colon cancer resection and prolonged abdominal ileus. I placed an NG tube, like I'd done numerous times before, and she aspirated, went into respiratory failure, and ended up intubated. My next ghost was a woman with terrible breast cancer who suffered every moment that I kept her alive until her body failed. I have all these shadows hiding in the periphery of my vision: the colon cancer that we didn't find soon enough, the breast cancer that didn't respond to any treatment, the heart attack that happened the day after I did a complete physical, the elective orthopedic surgery who died on the table, the blood clot that I didn't prevent. And it would be nice if these shadows were just that, painful memories that hide in the darkness, but they are more than that. These shadows had names like Evelyn and Erik and Nancy and Steven. They had spouses and parents and children and friends. They had jobs and lives and purpose. And they haunt me because I took those things away from them.
In reality, I didn't kill them. Bad things happen. As long as a doctor is not incompetent or negligent, then there is always a chance that even the most benign circumstance could end badly. Life is not fair. In fact, I've written about this no less than twice already: Perfection and Guilty. And living with the choices you make, that takes some adult sized diapers sometimes, but it's not quite the same as knowing that you took part in an event that resulted in the death of a person. And you have to talk to that person's children or spouse, and tell them what happened. How do you do that without seeing the ghost over your shoulder? If you can't deal with the shadows of your mistakes having names and faces, then medicine may not be for you.