- © 2007 Canadian Medical Association or its licensors
I went to work impaired yesterday.
I still can't believe it.
It started innocuously enough: I'm a dental coward. I still feel the drill no matter how much anesthetic is given, and so I asked my family doctor to give me a little lorazepam to help get me into the chair. We both figured I was a big guy, so 2 mg would probably be enough. I was to take one pill before bed the day before, and 2 mg one hour before the procedure.
We overestimated. I drove my car to the dental office and I can remember having difficulty staying between the lines. What actually happened in the dental chair was a pleasant blur; I remember nodding off a few times and being shaken awake by the dental assistant. Apparently, fillings and falling asleep don't mix.
Then I drove from the dentist to my office over a half-hour away.
In my right mind, I never would have attempted such a stunt. But I wasn't in my right mind. I was impaired, and making decisions accordingly. I'm lucky I didn't kill someone.
I made it to my office to find, as usual, that I had a full afternoon and evening schedule booked. To my embarrassment, a new doctor was having lunch with my group and, meeting them for the first time, I was obviously altered. I know this from feedback from the office staff the next day. I slurred my speech. I staggered. I looked drowsy. Yet despite this I felt able to practise medicine, and a day afterward I still can't comprehend how this came to be. Everyone in the office knew something was wrong, but no one knew what to do about it. Would that someone had taken me aside and firmly suggested I take the rest of the day off. (I don't mean to blame anyone else here. It's just a wish that I have.) Instead, I saw a full roster, and the greatest indignity was to come: eventually, as I worked from one hour to the next, I became gradually aware that I was not feeling well, that I was suffering the effects of the medication, that I had just seen 20 people while high. It was a feeling of horror that, as the night wore on, intermingled with disgust.
The next day, I apologized to my staff and to my colleagues for my behaviour. But that was the easy part: for I wondered where my responsibility lay with the patients I had seen that day. Should I recall every one and tell them that I was under the effects of medication when I saw them? After all, it's not like they could have been oblivious. I was staggering.
I work in a small community and this sort of thing could ruin a reputation, one I've spent years cultivating. It all could very definitely be blown by a misadventure on a drug.
The hardest phone call, though, was the one I made to the College. I felt I owed them a call; there was a public safety issue here. I told them my situation, and they seemed satisfied that it was an isolated incident and that I had taken the medication as prescribed. Their one piece of advice: stay off our radar. Don't do it again.
Today I think: I did that. I actually did that. It's still hard to believe how one innocuous event (needing sedation for a dental procedure) can turn into a disaster. All those bad decisions (driving to the dentist, driving to the office, working that day) were made under the influence of a chemical, reinforcing how as health professionals we need to be absolutely sober before we deal with patients' lives.
At least that's one of the lessons I'm taking from this.
— Dr. Ursus