“There is no easy way to tell you this…we think your son has a double outlet right ventricle (DORV).” At that moment, my world turned upside down.

As pediatricians and critical care providers, we thrive on complex cases, the sickest and rarest diagnoses. We give life-changing news, see bad outcomes, and experience complications regularly. Alternatively, families with hospitalized children hope for the routine because when a complication occurs, it happens to their child and affects their world. In theater, the invisible barrier between the actors and the audience is known as the “fourth wall.” When a violation of this barrier occurs (eg, an actor speaks to the audience), it is termed “breaking the fourth wall.” Likewise, when a medical professional receives a severe diagnosis for themselves or a family member, they cross the invisible line in medicine that separates the medical professional’s experience from that of the patient’s.


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