EP15 - Navigating Medical Malpractice: Dr. Gita Pensa on Litigation Stress and Resilience

In every operating room, in every ward, in every clinic, and every team meeting, a silent battle brews. Conflict, negotiation, identity. Welcome to the Scalpel and Sword podcast, where I, Dr. Lee Sharma, physician and conflict analyst, Explore the hidden negotiations behind modern medicine. Let's trade burnout for boundaries and learn the art of healing with precision and power.

Hello, my peaceful warriors. Welcome to the Scalpel and Sword podcast. I am your host, Dr. Lee Sharma, physician and conflict analyst, and I am thrilled to have on the podcast today, Dr. Geeta Pensa. Dr. Pensa lives in Rhode Island and she practices in emergency medicine. She did her medical school at the University of Pennsylvania and her residency at George Washington/Georgetown in Washington, D.C. She is currently adjunct faculty of associate internal medicine, associate emergency medicine at Brown University. She is the host and creator of the podcast Doctors and Litigation: The L Word. She has been a keynote speaker all over the country about the experiences of physicians going through the medical malpractice process. And she is also a physician coach who works with physicians going through the process. Dr. Penso, welcome to the podcast.

Hi, thank you so much for having me.

Thank you for being here. I think it's so amazing. I was looking through your speaking and your publications. You have really been a visionary in recognizing that when physicians go through this process of medical malpractice, How difficult, how emotionally tortuous it is. What first got you interested in working with physicians and delving into this topic?

Well, it was a very long road, as you might expect. It started with my entanglement in the legal system. So I was a defendant in a very, very long, really protracted case that started when I was about 5 years out of residency. And in the end, it lasted 12 years and I went on trial twice. The first, for 4 and a half weeks, there was a defense verdict, meaning a verdict in my favor. But then there was an appeal and it went through all the layers of courts in my state. And then the verdict was eventually overturned in 2015. And I found myself going back to trial again in 2018. And I had not been well. I really had been experiencing a lot of what my clients experience and a lot of what is almost normal to experience during litigation, which is a lot of fear and shame and uncertainty. And I had no understanding of the process. I'd never been taught anything about it. And I'd say even after my first trial, I still felt like I didn't have a great handle on the whole thing. I knew what they told me to show up and do, but I really didn't know anything about how to cope with it, how the overall system worked. I just, Tried to follow directions the best way I could. And so in between the first and second trial, well, really between the appeal and the verdict being overturned, I decided to make a study of 2 things. One, how does one dig themselves out of the hole of litigation stress and depression and anxiety and all the things that come along with it? And secondly, How do you do this better? How do you be a good defendant? What does it mean to be a good medical defendant? How do you do this well? And so I made a study of tort law and all sorts of stuff. And eventually, long, long story short, I became a coach and now I do witness preparation work for attorneys and insurance companies. And I speak a lot on this topic and try to raise awareness of it. I mean, it's sort of a funny thing to say, 'cause I think most of us are aware that it's a problem, but we just And haven't been doing anything about it.

Oh my gosh, you're so right. One of the things that really spoke to me as I was going through your podcast and your materials is that culture of silence and shame that is so complicit in that process. Because we don't like to talk about it. Like if anybody is in the midst of that, it's not something we verbalize easily and quickly. We feel like, I think we're the only people on the planet that are having that experience. Nobody else has been through this but me. And so therefore that feeling of, I'm a bad doctor, I'm a bad person, this is happening to me. And so we're not as likely to share that. I can think of twice in my career where I have had colleagues who came to me and said, I'm going through this process and I want to talk about it. And it were people that I was already friends with, but we were able to sort of kind of listen to what they were going through. But what you're offering doctors, which I think is so great, Is an active way of managing this process. You're actually teaching them how to walk through this process. As you started your study, were some key things that you talk with doctors about in terms of managing what goes on in the midst of this medical malpractice process?

Well, the first thing I did was listen. I mean, I knew what my experience had been, and so in the creation of the podcast, I actually started doing the interviews. That would form the basis of the first season of the podcast before my second trial. I knew I wanted to try to teach people about this in a different kind of way. So this is way back in 2017, and I went on social media and we're asking just random doctors, do you wanna talk about your experience in litigation? 'Cause I certainly knew mine and I wasn't a qualitative researcher, probably could have gone that route, but I really, really wasn't a researcher. So I just went out there and asked the question, does anybody wanna talk about their experience in litigation? I don't wanna know about your case. Usually people just wanna talk about the medicine in a case. I just wanna know about you. I wanna know, how did you fare? What did it feel like? What helped? What didn't help? What kind of support did you have? And so I wound up doing around 50 long-form interviews over that following year, and then using a lot of those excerpts in creating what wound up being a curriculum. The first season of the podcast is really this audio curriculum and the introduction to the problem of litigation stress, and then how do you come out of it? And what I really learned is that the shared experiences we have are one of shame, because that's how we've dealt with litigation, if at all, is just with this aura of shame around it, even though it is so incredibly common. I mean, depending on your specialty, probably the majority of us will be sued at some point. But if you can't name anyone around you or point to any of your role models who were sued, who had to go through this process, and you got to learn from them how to perform well, how to deal with it, how to manage everything, then you don't know. And the implication is that nobody that you know has done this. And so you become in your own head this sort of pariah. So that's one thing, 'cause we don't talk about it. And then the byproduct of that, of not talking about it, is that none of us are prepared. We all come in not having any idea about what this is truly about, how to perform well in it, how to strategize in it. We take it personally. We make it mean a lot of things about us that it's not meant to. And we don't understand how to quote unquote play the game. And so we're really depriving ourselves and really amping up the fear and anxiety that go along with it that become almost universal. When anyone enters into litigation. And so starting to work around those 2 things, both the knowledge deficits and the shame, that's what I've been attempting to do.

Wow. I think that's such a great observation. We do tend to be very siloed as we progress through our medical education. We're taught to be autonomous, we're taught to be independent. And I think as clinicians, sort of that way of working is something that we're familiar with. But when it comes to going through the process of malpractice, it doesn't serve us very well because we're not good at interacting and reaching out to our colleagues about stuff, especially stuff that we hold very close to us. That feeling of shame and guilt and feeling like nobody else has gone through this. And like you said, it's not something we're taught to work through. We're not always going to offer that to a colleague. We're not going to want to share that necessarily. So sometimes I think that's inherent in our education.

Yeah. It is sort of implicit that you shouldn't be talking about it or that you shouldn't be asking for help or that asking for help is a sign of weakness, but it's also explicit. So many times the attorney or the insurer, when you show up for your first meeting after you've been sued, will say that, okay, you only talk about this with us. Like you only talk about this with your legal team. And this is something that I've been trying to work with the insurance industry about because this is categorically Both unfair and unproductive because what you're doing is taking an individual who, and I can lay out all the ways in which this is actually for many people a traumatic experience. You're taking a person who's been traumatized and the party line is you're not allowed to talk about this, which is bunk. It's because attorneys wanna keep their cases buttoned up. I get that. But the biggest risk is that you talk to somebody and then you have to reveal at deposition that you talk to them and then perhaps they'll get deposed. So if we know how to be smart about how we talk about it in terms of talking more about the feelings and the general events— I mean, what's in the complaint is public record— and knowing what's case detail and what's not, the way that we're smart about HIPAA, for example, it would be a lot better for everybody. And we could get the help and support that we need from one another.

Absolutely. You had an op-ed piece in Time magazine in 2023. I think this is one of the things I love so much about your work. And you spoke to the American Bar Association in 2024. You have been an active ambassador for all physicians about what this experience is like for doctors, especially people who maybe are not in the medical profession. But one of the things that you mentioned in your op-ed piece in Time magazine was, as people start to go into this process of malpractice, one of the things that starts to happen a lot of times Is different parties will start throwing each other under the bus. And so this communal act of going through malpractice— physicians, nurses, medical facilities, all everybody— it creates this sort of culture of conflict, if you will, because everybody's trying to figure out where to point a finger. How do you teach physicians to work through that?

The first thing to understand is that this is really all about money. If you can take away the fear, right? The fear and the shame and start to look at this as sort of a strategic pro— now, I always tell people when I start working with them that there's really 2 goals, right? One is to really think about and process and feel deeply around the adverse event itself, for which we will have very strong feelings if we were responsible or if we cared about this patient. I mean, we've got a lot of feelings about that and those have to get dealt with. The problem is that the legal arena is not the place to do that. The legal arena is all about strategy. It's all about money. And what you'll find is that unless you understand the perspective of the various stakeholders, you just have this sort of unmitigated catastrophic fear of everything. If you learn the skills required, you're going to have to thread a needle sometimes, right? There is a way for you to defend yourself. Without throwing everybody else under the bus, right? Oftentimes these days, it's not a good idea to do that because it's a bad look for everybody involved. And juries often aren't nuanced enough to understand like, this person has fault, but that person doesn't, or they know there was malpractice, everybody's getting hit. And when you're fighting with each other and you're making each other look bad, it just makes everybody look bad. So that's one thing I sort of work with people like, you don't get to avoid any sort of blame or consequence because you're pointing the finger at somebody else. It almost never works out that way. You just get lumped in there too. You just drag more people in. Yeah. Right. The other thing is you have to understand whose money is at risk. And so one of the things that I teach people, most doctors don't know a thing about their insurance policy. They don't know anything about their malpractice policies. They don't know who's writing the check. They don't know under what circumstances their own assets would be at risk. If you're working at a large hospital system and you are employed by that hospital system, most often you are in a shared defense situation, in which case you are all in the same boat. So when you start infighting, it's bad for everybody. It does not save anybody anything. And usually in those situations, your assets will never be at risk. It's almost always— I won't make you any promises. I've learned a lot from my legal colleagues, but it is almost always the case that in that sort of situation, the hospital takes on excess liability. And so understanding what is truly at risk, is it of any strategic benefit to me to throw somebody else under the bus? It almost never is.

Mm-hmm.

And then learning how to stop letting fear, just unmitigated catastrophic fear, drive everybody because nobody makes great decisions from a place of fear. So the more we're comfortable with this arena, which you can get to be, believe it or not, I'm actually involved in another lawsuit right now and it's a very different experience for me because I understand. And so I'm very different than the person I was in 2006 and '07, right? Developing a knowledge base around it and then understanding the nuances, strategy, that's what really the podcast is about to get people understanding, like, I've got to know about my policy. I've got to understand how to perform in this environment. I need to know how to operate on this other planet. And that doesn't mean that you just shoot everybody else around you because the circular firing squad is never a good place to be. Wow.

I love how you talk about threading the needle, you know, actually understanding that there's a way to navigate, but you have to play the game. And I think that is something for so many of us that we don't understand for us, it's personal, it's emotional. Like you talked about so beautifully, it is a fear-based decision-making process. And we never make good decisions in fear, especially if we are working in a system with other people. If other people don't understand how fearful we are and we're going through this process and we start finger-pointing or blaming or trying to say it wasn't my fault, it was this person's fault, that all of a sudden, that's not like you said, that's a fear-based response, but the other person who we're dealing with may not realize that we're coming from that place of fear. We may have walled it up and they don't really perceive that. But also too, I love how you talk about the fact that this is about money and strategy, because I don't think that's something doctors get. I know what my daughter is, an attorney. She's civil litigation. She does not do any kind of med mal. Absolutely not. But one of the things that she learned in law school is sue everybody. That's what they're taught to do. And the reason why they're taught to sue everybody is because that's where all the money is. They're trying to get more money out of the situation. But until I heard her say that the first time when she was going through tort class and she's telling me, yes, first thing they teach you, sue everybody. And honestly, as a doctor, that was the first time I had ever heard that verbalized. And that was a big lightbulb moment for me to hear a lawyer say that.

To hear an attorney do it. I want to make a small correction that med mal does fall under civil litigation. It's like a tiny little specialized branch for tort law. So it sounds like she doesn't do med mal, and med mal tends to be very specialized among tort law. And so if you're being sued by somebody who does all kinds of law, there are people who really, really specialize in this. Just as you want a defense attorney who specializes in medical malpractice, you want that kind of specialized attorney.

Right.

So yeah, it's pretty interesting, like what they say amongst each other versus what They say to a potential client is very different, right? Obviously, when I say it's about money and strategy, for the doctor has very intense feelings about it, and the plaintiff's attorney is often using this to masquerade as a way to make the healthcare system safer.

Mm-hmm.

Except that if that were actually what they were after, they would support more of a communication resolution model. And so by that, if anyone's interested, there's something called the Michigan Model, which Rick Boothman out of the University of Michigan started. It's really espoused by larger organizations now. Every patient safety advocate out there really thinks that this is probably the way to go, but this is a way in which everybody talks early. It's not about getting the nuclear verdict. It's not about extracting every single dollar and every single cent from every single pocket that you can get. But that's not what a lot of plaintiff's attorneys are interested in doing. And so, yeah, there has to be a system like this. There is such a thing as medical error. We all know that bad things happen and sometimes unintentionally bad things happen. Sometimes they happen by mistake. Nobody gets through a career without some terrible event like that happening. Sometimes it comes along with litigation. Sometimes it doesn't. Sometimes you're sued for things.

Mm-hmm.

That you're like, where did that come from? I did everything right.

Yeah.

They don't match up exactly. And so we need a better system really of adjudicating medical care that's outside of the civil litigation system, which was really always just meant to be a dispute resolution system. The way that dispute would be resolved would be, am I writing a check? That's it.

Yeah.

It's meant to be transactional. The rest of it, we just throw on top of the system because we don't have any other way to do it.

That's such a great point too, that unfortunately a lot of times people don't feel like they have any other recourse. This is why it ends up in terms of medical malpractice litigation. They don't see that they have another way. And when you're driving around everywhere and you see billboards everywhere for personal injury, you start to think, well, is this my only way of addressing an issue? Because nobody knows that anything else is out there. So It's very hard to provide if there is an outcome or if there is an event and the patients don't feel like they have a recourse. They don't know that there's another system, but they see the billboard. I think that's a big part of it as well.

Yeah, and they may have been stonewalled by the system. I mean, a lot of risk management organizations are stuck in the dark ages where they will tell people like, okay, like now don't talk. They don't—they want to be—they want the lawyers in the room when you disclose an error. Like. Obviously that's gonna make everybody upset, right? They want, they wanna be the one to disclose themselves to the error themselves. They don't trust the doctors to do it. Like, this is insane. Like, we need to take our relationship with this patient back. It should not end when something bad happens. Like, this is absurd that we've actually like given this over to all of these attorneys out of what? Out of fear because we don't understand the system. Now, I'm not saying to go in there and fall on your sword when you really didn't do anything wrong. Like you don't, again. Fear, emotion, when emotion's driving the bus, like you may not be able to talk about things, but if you are clear and level-headed about it and you understand how to have these conversations and communicate well, like we should be in charge of that. This is crazy.

Yep. One of my favorite terms in terms of looking at when we have complications or unintended outcomes and we are going through that is the idea of compassionate accountability. We're still accountable for what we have done. If we make a mistake, we're going to own that mistake. And that compassion is going to the patient. I made a mistake and I'm sorry. And having that be, this is what happened, and being transparent with the patient, as opposed to, like you said, not saying the words, I'm sorry this happened, having the attorney in the room. I think that is something I've heard from colleagues sometimes being told to don't say you're sorry. But that's part of building that relationship in terms of When you talk about escalating conflict, to me, the fastest way to escalate it is to walk in the room and not be transparent and accountable. So I think when we are transparent and accountable, can we stop the process before it even starts? We are not even allowing it to get to the point that we are escalating by having other people in the room. And again, that might be a fear-based motivation. I'm scared something's going to happen, and so I'm going to bring this attorney in and I'm not going to say I'm sorry. And all of a sudden we've escalated the situation. To the point that it's a lawsuit.

Right. And part of the problem is that all we're ever taught about this whole thing is risk, quote unquote, risk management, right? Mm-hmm. And so the problem is that sometimes what we're taught about risk management comes at the expense of the actual human relationship we have with our patients. Mm-hmm. Yep. And you have to understand everything and all the nuance. Like once you understand, like again, some of it is threading a needle, but like once you understand, like yes, there is a way to have an open, honest communication With this patient without it becoming some sort of a terrible liability for me? And we can get into I'm sorry laws and things like that, but you should be able to have a really honest, caring conversation with your patient. If you have a relationship with a person, I mean, when you have a human relationship in your life, a loving relationship with someone, and you mess up, what do you do? Right? You sit down with them. And you talk to them and you do say you're sorry if it's an error, right? If there is a frank error, that thing is coming out. Okay. So, I mean, sure, lawyers are going to listen to this and be really upset with me, but I mean, for me, the most important thing to me is like the doctor-patient relationship, because once you've put litigation itself, you don't want to shoot yourself in the foot. But I mean, so much of it is not based in your medical care or even reality half the time.

Mm-hmm.

But what needs to come out of this is you as a human being feeling like you did right by your patient and that person as a human being feeling like you did right by them. And that doesn't always mean perfection, but I do think that we owe each other a better experience in medicine. We owe each other better relationships. And when you are vulnerable enough to have these meaningful relationships with your patients, And not be afraid, then there's actually a lot of restoration in the enjoyment of medicine, like what we all came here for, right? Like we should be getting out of this what we came for. And that's it. It's the deep, meaningful stuff. It's the wins, but it's also when the losses happen, what do you do? How do you show up? And that is something a lot of us have lost experience with. And I think that's too bad because there's a degree of professional maturity I think that's required. To attain the ability to have those conversations well, and we all need it. I think that's really part of becoming a wiser, better physician.

Wow. That's so beautiful how you say that. Unfortunately, so many people have lost that joy of practicing medicine because you've got this low-grade hum in the background that you're always afraid something like this is going to happen. It's like instead of actually interacting and enjoying that interaction with our patients, We're so afraid that, oh my gosh, something's going to happen. I'm not going to be perfect. I'm going to have X happen. And as a result, we don't walk in with that openness and that enjoyment of what we're doing. We walk in afraid, constantly vigilant, that hypervigilant, hyperaware survival mentality instead of actually being transparent and actually finding joy in what we do. And so I think that's why the work is really important.

And you know when you care about them, right? Oh yeah. As a patient, you can tell if your doctor is invested in you. You can tell if your doctor cares. You can tell in a matter of minutes. Right. And so, I mean, patients deserve you caring about them. And if you're trying to detach yourself and be as clinical and distant as possible, because you're just thinking about all the angles, like that's not fun.

Absolutely. So in your work, you are a coach, you work with physicians who are going through this process. So you have a lot of clients. Is it mainly physicians that reach out to you? They find you and they're looking for support? Is it attorneys who are reaching out to you? Who engages you in the process most commonly?

It is becoming more and more attorneys, right? Or claims professionals. But a lot of physicians still reach out to me individually. It's a healthy mix. I mean, when I started off, it was really just physicians sort of self-referring, and then the more I became a known entity to the legal side of things, now I get a lot of my referrals through lawyers. Yeah. So it's a mix. The interesting thing is the people who self-refer, and it's not all doctors, and I have PAs, I've got nurse practitioners, I've got social workers, I've got dentists. You know, if you can get sued, we all feel about the same about it. Each specialty has their own really interesting aspects to it. Mm-hmm. Which I've learned like the more I've done this work, cuz my perspective is the doctor, but it is really interesting. But yeah, so now the people who self-refer are usually ready, like they're ready to be coached. They're looking for help. A lot of times now when I get referred people from attorneys or from insurance companies, it's Like, you know what, we've got this defendant who is falling apart and completely help resistant, and we don't know what to do with them. And so that's a tougher ask, but I'm getting better at it.

Wow. It's a really fascinating phrase, help resistant, that they are in this situation and everybody around them can see that they need this assistance and this help, but they can't see it themselves. And so here is your wake-up call. We're going to call in somebody who's going to help you raise your awareness about the fact that you need help. And especially because you are a physician, you are a colleague. And I see this in conflict resolution all the time when I go in and I mediate disputes a lot of times. And usually by the time they're calling me, hospitals, whatever, they're in their last resort. I mean, they've already been through this. This conflict is hardened. But part of the reason I get to go in there sometimes is because I am a physician. So even though I'm a mediator, I have that extra little bit of credibility that I can walk in there and it's like, oh, I'm a doctor, but I'm also a conflict analyst. And so I think you being a physician and coming into this situation is so beneficial. I think it makes a big difference in what we can do, what you do for them. I think that's so cool. I love the fact that the American Bar Association called you to come speak. I love that so much. What was that like?

That was awesome. It was awesome. I think I had spoken at a number of smaller legal events before that, and I've just had some wonderful sponsors along the way that were, you know, we want you to speak at this next thing. We want you to speak at this next thing. And so that was a real thrill for me last year to speak at their healthcare law summit. And yeah, it was very well received. I think attorneys do know that this exerts a toll on us, but Because they don't really live in this world and because we try to put on a good face. I always tell 'em it's probably the tip of the iceberg. If you're seeing any sort of distress, I could tell you there's a lot more of that happening at home than you can see because we're really good at hiding our distress and hiding weakness because we were really taught to do that during training. But really giving them a very clear understanding of where the distress in their defendant is coming from in an analytical way, and then Illustrating like, these are the things that we need to do to work on those things, that this is something that we can do together. It's not just the job of doctors to educate themselves, and it's not just the job of lawyers to say like, okay, show up and say, you know, talk like this when I tell you to. There are a lot of missed opportunities along the way. I mean, litigation's long. There are a lot of opportunities for education, course correction, coaching. There's usually ample opportunity for that.

One of the things that you put in your Time magazine op-ed that I think was so important that you started to draw people's attention to was the suicide rate that goes with physicians, especially physicians going through litigation. You know, I think it was very expressive of the level of mental anguish and stress that people experience going through that process. As you are talking to attorneys, as you have maybe people who aren't in the medical realm and you're talking to them about that process, is that a surprise? I mean, You know, like you said, we present ourselves as being very self-possessed and we try to act professional and hide our emotions. So the fact that there is an actual elevation to the point that there's an increased suicide rate, is that something that surprises people who aren't in our world?

They are usually surprised by the fact that physicians in general have a much higher rate of suicide than the general population. That That seems like interesting to them. But the people who do med mal work are not surprised that it's a driver of suicide because most of them will have heard a story.

Wow.

Uh, and so they know that it's there, but to really hear it in stark terms, and we didn't have, nobody asked the question for a long time. So we didn't actually have data to show that civil litigation and Suicide were linked among healthcare workers. Now we do. There's been some great work out there that shows that there is an association, like that is probably a driver. But, you know, before that we had notes, so we just knew like, okay, they were going through a hard time. And it's interesting you mentioned that op-ed. I was pretty nervous writing that op-ed because when you write about medical malpractice for laypeople, mm-hmm. You will almost always get a real pushback from people who are unsatisfied with the healthcare system or feel like they have been, and it may have been, the victim of malpractice. There will always be someone shoving that really erroneous statistic that medical error is the 3rd leading cause of death. We could talk about that all day, but like, anyway, like we're up against a lot in terms of getting people to trust us.

Right.

So I got some of that, but I also got a lot of correspondence from people who were family members of healthcare workers who had taken their lives during litigation. And this was the first time they had ever seen anyone talk about it publicly. So there is this unspoken, terrible distress happening, this sort of collective distress, except we're all doing it in these silos, as you said. And I do think that we need to start being open about it. I do think that having better systems, not only of support, but just this eradicating the shame around it. Litigation doesn't mean what you're making it mean. It just doesn't. And the perfectionism that drives, honestly, the suicidality and everything else, and we can get way into that some other time. Perfectionism is not your friend.

Right.

But that Is all stuff that I think we've got to start looking at, but the suicide, the numbers are jarring. And so when we take a step back and think, okay, like this is a big problem, what are we going to do? Yeah. Then we have to start looking in detail at all the ways that this is. There's a quote that I love that essentially says that the person who best describes the problem is most likely to solve it. And we're still in the describing. Yeah. Like we haven't really ferreted out all the possible ways and it's going to take more than one solution. It's going to take a lot of different things to move the needle on it. But I think we better get busy.

No, 100%. That's beautifully said. I loved when you said in the op-ed that this process is thorny, that, you know, it's prickly sharp and it hurts. And being able to admit that it hurts is huge. I think admitting that there are things that hurt us that really change how we see ourselves, but also to understanding that how we see ourselves as part of how we see the process, that if we're demanding a perfectionism of ourselves, that we are going to be harder on ourselves. And we're going to view that process through a very different lens than maybe somebody who's come to terms with their, I don't want to say humanity, but the idea that we are all human and fallible.

Yeah. And you mentioned compassion before, like coming into it with compassion for the patient, disclosing error with compassion. The compassion is like a round thing. Like you should be compassionate on your end. And that's not as an excuse. I mean, there's a lot of the work of Kristin Neff is amazing. Like looking at all the reasons why self-compassionate people fare better during these. It's not giving yourself a pass. It's just understanding that you're human and humans do make mistakes, but those people tend to be more accountable and more able to go in openly and vulnerably into a situation to think about what does this other person need?

Yeah.

Because they are kinder to themselves. They are not afraid of this torture chamber of a mind they're gonna have to live in forever. And that actually makes them more generous in their ability to help the other person. They're not so engulfed in pain in their own head that they're just gonna shut down and pretend it didn't happen or lie or hide. It's an essential ingredient in all of this. And that feeling of self-compassion is something that's more protective against depression, anxiety, and suicide.

Yes. Yes. I love what you're doing. I love how you are helping people not only navigate this process, but you're also helping them learn to navigate themselves because this is also a process of learning the things within ourselves that as you say, change how we view this process. And I think that the work that you're doing is pivotal. I think it's incredible. One of the things that I think you've talked about is in this post-pandemic era, you know, we had this brief period of time where people were very supportive, I think, of the medical profession during the pandemic, and that window passed quickly. And so now we are in a space where, as you said, we are earning in many ways the trust of our patients. And trying to strengthen those relationships. And I think the work that you're doing is not only just helping people that are in the middle of a medical malpractice defense, I think the work that you're doing is helping people maybe stay out of that space because you're helping them understand themselves and understand the process that leads to medical malpractice. I think the work that you're doing is amazing. If people want to find you, Dr. Pensa, how would they best find you?

So my website is doctorsandlitigation.com. And you can contact me through there. The podcast is called Doctors and Litigation: The L Word. That's on all the major podcast carriers. And yeah, I welcome any correspondence.

Awesome. And we will definitely link all that in the show notes. Dr. Pensa, thank you so much for being so generous with your time and wisdom. I really appreciate you being here.

I really appreciate the invitation. Thank you so much.

Absolutely. Peaceful warriors, thank you for joining us today. It has been a pleasure to have you here, and until next time, be at peace.

Every episode is an invitation to speak, to negotiate, to choose. I'm Dr. Lee Sharma. Join the dialogue by subscribing to Scalpel and Sword. Until next time, peaceful warriors, may your choices be sharp and your voice be even sharper. This podcast is a reflection of lived experience and research in conflict resolution. The Scalpel and Sword is not intended as medical or legal guidance. For personal matters, please consult a qualified professional.