Julian Sheather on making mistakes

When I was a child I had three basic approaches to making a mistake. Firstly I would run away as far as possible and pretend it hadn’t happened. Secondly, if this was unsuccessful, I would surreptitiously hunt around to see if responsibility for the mistake couldn’t be handed over to someone else, or at the very least shared with them.

The third and more creative approach was to try and find a way of making out that it wasn’t really a mistake at all. This involved finding a novel perspective from which the apparent mistake could be seen instead as a thoroughly desirable outcome.

I know I’ve broken your grandmother’s vase mum but at least you won’t have to dust it any more. Although I have to admit that the impulse to duck responsibility for my blunders is alive and well, I couldn’t help noticing as I got older that these approaches had a tendency to backfire.

To the embarrassment of making the mistake was added the ignominy of being seen avoiding the blame. And so began a long and uncomfortable relationship with a host of errors, a relationship that, if the past is any guide to the future, is likely to accompany me to the grave.

Like the best of relationships though, mine with my mistakes has undergone change. I have noticed over recent years that they make me less miserable, or miserable for less long. Partly this is to do with recognising their inevitability.

Decisions are almost always made on the basis of imperfect information and, in spite of our best intentions, we cannot get it right every time. Another thing I’ve noticed is that in interesting ways I am disclosed to myself through my mistakes.

Unflattering light can be very revealing, provided we have the courage to look, and our failures can reveal more about us than our successes. I have noticed, for example, that I have a tendency to repeat certain mistakes, or to make mistakes in certain fairly predictable areas, and it is only by trying honestly to confront them that I have learnt when I should be on my guard.

I still make them, of course, but I make the same ones less often, which feels kind of reassuring. The road to self-knowledge seems to be paved with our blunders.

Another thing I have learnt about mistakes is that when they affect other people, it is almost always a good idea to own up and apologise. The impulse to conceal our mistakes stems in part from the fear of being criticised.

An honest and open apology, particularly if it comes before they’ve spotted your hand in it, can work wonders. Certainly my long acquaintance with my own mistakes has made me more tolerant of others’. It has also shown me how difficult it can be, and how much courage it can take, to own up to them.

The bigger the cock-up the more our sense of who we are is at stake and the stronger can be the impulse to conceal it.

In medicine of course, some mistakes can have disastrous outcomes. People can be seriously harmed or even killed. In these circumstances the emotional impact of making mistakes and admitting to them can be enormous. I have heard cases where doctors, depressed and debilitated by guilt over a serious mistake have taken their own lives. “No disease of the imagination,” writes Samuel Johnson in Rasselas, surely one of the sanest books ever written, “is so difficult of cure as that which is complicated with the dread of guilt.” The great benefits that doctors can bring to their patients come at the risk of great harms. Although rigorous training and robust systems can reduce those risks, they will never be eradicated. Living and working with these risks is a defining feature of the profession of medicine, and is, in complicated ways, allied to its rewards.