Feature

Breaking through a ‘cloud of silence’


 

‘A very calm demeanor’

In the emergency department, Dr. Matt Seaman was known for his unwavering focus and steady direction.

No matter the complexity or circumstance, Dr. Matt Seaman kept his cool and led with confidence, said Jim Perez, MD, an emergency physician based in Friday Harbor, Wash., and longtime friend of the Seamans.

“We would have multiple traumas come in or cardiac arrest,” Dr. Perez said in an interview. “Some docs get excited and start raising their voice or yelling, but Matt always had a very calm demeanor. I never heard him raise his voice. He was a calm leader.”

Serious and logical, Dr. Seaman was not one prone to belly laughs or demonstrative displays of emotion, but he had a soft spot for children and mentored many young people, said Jared Bower, a longtime friend and colleague. He was especially close to his daughter, Heather, and the two shared a special bond, Mr. Bower said.

“I have never seen [Matt] more happy than when he walked his daughter down the aisle,” said Mr. Bower, who officiated the wedding in September 2016. “It was as if some of his solemnity seemed to melt away, and he was truly happy.”

Double-boarded in internal medicine and emergency medicine, Dr. Seaman had a thirst for knowledge that led to expertise in myriad subjects over the years. He taught classes in advanced life support, launched a desktop publishing business, and wrote books with his wife on palliative care and pediatric pain management. Outside of the ED, he became a proficient two-step dancer, artist, skier, and environmentalist.

“He never quit learning,” Dr. Linda Seaman said. “He was always reading, studying, learning. He loved being the expert. Whatever he did, he did it well.”

Resilience was part of his nature, friends and family say. As a young couple, the Seamans experienced a series of heartbreaks while trying to grow their family, including the loss of a son at birth. The couple pulled through together, welcoming Heather in 1993.

“We’ve been through things that can blow marriages apart,” Dr. Linda Seaman said. “I think it brought us closer and strengthened our faith.”

Throughout his career, Dr. Matt Seaman worked through unsupportive work environments, job transitions, and ever-growing clinical demands. For example, he was named in three malpractice lawsuits and prevailed in each instance, his wife recalled. Court records show that he won one legal challenge at trial and that he was removed as a defendant from the others.

Despite his resolve, 35 years in the emergency department had taken their toll. After a taxing few months navigating administrative turmoil in the hospital, Dr. Matt Seaman told his wife that he was finished with medicine, she recalled.

She remembers him saying, “I can’t handle this insanity, anymore.”

‘Perfect storm’ of stressors

It’s no secret that workplace pressures can weigh heavily on physicians’ mental health.

“The stressors in medical practice today are very real,” Dr. Myers said. “So many doctors feel they’re spending so much time on documentation that they’re getting less and less time with their patients. They’re expected to see too many patients in too short a time, and they feel like they’re on a treadmill.”

Chronic job stress frequently emerges as physician burnout, defined as a combination of overwhelming exhaustion, depersonalization and detachment, and a sense of ineffectiveness and lack of accomplishment, said Carol A. Bern­stein, MD, psychiatry professor at Albert Einstein College of Medicine, New York, and a past president of the American Psychiatric Association. But she noted that the term “burnout” is defined differently by different people.

Dr. Carol A. Bernstein, psychiatry professor at Albert Einstein College of Medicine, New York, and a past president of the American Psychiatric Association

Dr. Carol A. Bernstein

“When looking at physicians, the burnout rates really vary by specialty,” she said in an interview. “On average, we’re looking at burnout rates of between 40% to 50%. It’s higher in frontline specialties like the emergency room and in some surgical specialties.”

Malpractice claims can add another layer of stressors, said Louise B. Andrew, MD, JD, an emergency department physician and national litigation stress counselor. By age 55, nearly half of physicians will face a lawsuit, according to data from the American Medical Association.

Dr. Louise B. Andrew, an emergency department physician and national litigation stress counselor

Dr. Louise B. Andrew

From an often unexpected filing to a demanding deposition to a traumatic trial or settlement, litigation can cause deep mental, emotional, and physical stress, Dr. Andrew said in an interview.

“I’ve never met a physician who wasn’t greatly stressed by malpractice litigation; even talking about it raises their stress levels,” she said. “Being sued is one of the most stressful things that can happen to a physician.”

In addition to workplace stressors, the overall payoff for practicing medicine has diminished, Dr. Bernstein said.

“We’re prepared to give up things to do medicine, but you want to have a sense of efficacy in what you’re doing; you want to feel like you’re helping patients,” she said. “Increasingly, our autonomy and control are being removed, and this makes it very hard to get the balance. The scales have tipped so that the negative aspects of being a physician are starting to outweigh the very strong positive aspects. That all contributes to burnout. It’s a perfect storm to some extent.”

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