7 - Shame in Medicine: On Trial
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What is the episode’s introduction and why does litigation shame matter for physicians?
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Thanks for listening to the Nocturnist Shame in Medicine: The Lost Forest. If this is your first time tuning in, welcome. And I actually recommend you rewind and start at episode one. This is a series that builds on itself over time, so starting at the beginning will definitely lead to the richest listening experience. Enjoy the
show. So um my attorney every day before court and on the first day especially I had to meet at him at his office and he was like I'm gonna drive you to the courthouse And it was interesting because he drove me in a pickup truck. He and the j junior attorney sat in the front and I sat in the back with like all the dog blankets and whatever and he was like People are gonna watch you get out of the car. So from the minute we get there, there are optics involved. So you're getting out of the back of this pickup truck. And um and then we're gonna go in. I was okay. And you know, walking in, it's you know, it's an imposing building. I'd I'd never really been in a courtroom before. There's the whole going through the metal detector and
marble halls and the sound is echoing everywhere and there's the clickety clack of people wearing high heels and Lots of people in suits and lots of people who aren't and who are there for criminal cases or whatever. But I was very much like a deer in the headlights thinking what What is happening right now? All eyes are on you. Judge starts giving you instructions and giving the jury instructions and you just I liken it to being like Alice in Wonderland, you know, you fall into this hole. Nothing makes sense, you don't even know who to trust, you don't know what to believe, you don't know if your skill set's gonna help you in any way. You have no idea what the heck is happening.
You're listening to the Nocturnous Shame in Medicine, The Lost Forest. I'm Emily Silverman. Today we're gonna be talking about shame and litigation. A lot of people think that only bad doctors get sued. Or at least that only other doctors get sued. But actually It's a thing that happens to many, many people in the health care field and can be a huge source of shame. Mostly we'll be exploring this theme through the story of Dr.
How does the first guest describe the experience of walking into a courtroom for the first time?
Gita Penza. An emergency medicine doctor in Rhode Island, whose voice you just heard. In many ways, Gita's story is incredible. But in other ways, it's actually quite average considering how often doctors deal with litigation stress. I'll let Gita take it away once again.
In two thousand six, I was a pretty young attending. I was about five years out from residency, and I was working In a community hospital at the time, I was a nocturnist. I was the only doctor in the hospital at night and I really Loves what I did. You know, I would Run the emergency department. I'm an emergency physician. And then I would have to go upstairs to run a code or intubate someone. Come back down to my department, maybe go up to labor and delivery because we didn't have OB in house at night, deliver a baby, come back down. It was terrifying at times, but it was absolutely where I felt like I belonged. And Then one night I took care of a young woman. She was around thirty years old and she came in with a very complex
Very confusing presentation. And I spent a lot of time. With her. And her husband trying to sort out what was going on. And I did a very thorough physical and I think I'm not sure. revisit her probably five times during her visit. I imaged her, I called a consultant. I woke them up in the middle of the night. I was worried. And in the end, I wound up discharging her with a plan in place to see a specialist at nine AM that morning, three hours later. But she never made it there. Instead She went home and went to bed and about an hour later she suffered a massive stroke.
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Chapters
6 chapters
1
What is the episode’s introduction and why does litigation shame matter for physicians?
0:00–2:40
2
How does the first guest describe the experience of walking into a courtroom for the first time?
2:40–8:50
3
What triggered Dr. Gita Penza’s journey into medical litigation and how did she first learn about it?
8:50–15:56
4
How did Dr. Penza cope with the emotional fallout after being named in a lawsuit?
15:56–26:26
5
What role does shame play in medical culture and how can physicians address it?
26:26–38:28
6
How did the second guest’s wrongful‑death case unfold and what ethical dilemmas arose?
38:28–41:15