24 Mar, 13 | by Ian Wacogne
There’s a great TED talk by Brian Goldman called “Doctors make mistakes. Can we talk about that?” After a pre-amble which is pretty North American – baseball stats, which he makes thankfully very clear to those of us who simply don’t get it – he describes the fact that he makes mistakes in his medical practice.
One of the most striking aspects of the talk is the honesty and bluntness with which he describes himself. He recalls his first bad mistake, and his promise to himself that he would do better in future. Of course, he does do better – for a while. Most of us would not wish to see a doctor who did not daily try to better him or her self. But then he makes another mistake. And another. And after a while he realises that making mistakes is part of his career. This doesn’t make him a bad doctor, but redefines for him what a good doctor, and at this point I’ll quote him direct:
The redefined physician is human, knows she’s human, accepts it, isn’t proud of making mistakes, but strives to learn one thing from what happened that she can teach to somebody else.
A recent Horizon programme on the BBC travelled a similar route, with the extraordinary Chesley “Sully” Sullenberger noting that most of the rules which governed his behaviour during his 205 seconds of crisis on US Airways flight 1549 were hard won, a consequence of errors where others had paid with their lives.
This whole area of error is immense, and it has to be acknowledged that medicine is a long way behind other industries in its ability to look honestly and openly at error and its consequences. I was planning to write quite a lot about this over the next few weeks and months, but just as food for thought for now, let me share a question I’ve started asking medical students in clinic. The question is “What would you do if I were about to make an error?”, and I’ve yet to have a student not look utterly perplexed by it. I’m learning nearly as much from the answers as I am from the effort it takes me to ask it.