Tuesday, February 17, 2009

the error of my ways

I haven't had much to say lately - mainly because my mind's been on other things; things I haven't wanted to talk about. I've been waiting until a cheery topic came along, but I've decided hang it all, I'll write about this.

I made a mistake at work. (Although it is by no means the first time, I still get a small lurch in my stomach just to write these words down.) It was not an error due to lack of care, or laziness. It was not even an error due to lack of knowledge - the type of faulty diagnosis that haunts my dreams some nights. No, this was a simple case of misremembering routine guidelines, getting muddled, being wrong. I gave a patient incorrect advice, telling him that certain steps were not necessary. Thank goodness, due to an inbuilt follow-up system, I discovered my mistake. I have contacted the patient, and revised my advice. I have taken the appropriate steps, and, although the results are not yet final, it seems that the end result for the man concerned will be unaffected. However. What scares me is not so much the consequences of this particular mistake (although I won't truly relax until I know the definite outcome for this patient), but rather the failure on my part. My brain let me down. My brain let this patient down. And however sweet anyone I've told has been - telling me I'm only human, I should forgive myself an honest mistake - the fact is, I did wrong by a patient. Their health could have been affected. It's one thing to be, say, a travel agent, and stuff up a hotel booking for a client, but its another altogether to mess with someone's life expectancy.

Rationally, I realise I cannot be perfect, and that I will inevitably make mistakes. But a voice from the centre of my being shouts You can't afford to make mistakes! Your patients trust you with their very lives!

So what is the solution? How do I make this better, how do I sleep at night? I have recalled all my patients with the same condition in the past year, to check that they have been correctly managed. I have talked over my medical misdemeanour with colleagues; I have confessed to friends. I have felt anxious and uptight and distracted and ashamed. In the end, I can do nothing. I can try to do better, to be more careful, to read more journals. I just try to let the anxiety wear away over time, wear thinner and thinner until it is as fine as gossamer and I barely notice it.

Until the next time.

22 comments:

John Cowart said...

relax.

We patients pay less attention to what you doctors say than you think we do.

Once my urologist gave me all sorts of information and instructions but when we got home we realized he'd been advising me from another patient's file and test results. I'm John, not Ralph. The doctor just got us confused; after all Ralph is also a male patient.

No problem. We caught the mistake and corrected it. No harm done.

As far as waiting for something cheery before you write... I'd never write anything if I waited to feel happy.

You come across as an honorable person. Don't sell yourself short.
What you do--even your msitakes-- is a great value. (and no, I won't correct that).

John Cowart said...

Back again hours later; I've been thinking about this.

I think I notice a key: "you said, Thank goodness, due to an inbuilt follow-up system, I discovered my mistake".

Your built-in followup system.

It worked.

It did just what it's supposed to do. Even astronauts rely on backup systems.

The very fact that you instituted such a followup program shows you exercise every care to negate mistakes. Good for you.

Peace.

Motherkitty said...

Say your mea culpa and let it lie. You have done what you were supposed to do. And, as Mr. Cowart said, your back-up follow-up system worked and that's the way it's supposed to be. The patient didn't suffer and you corrected the error of your ways. And you really did abide by the first rule of your oath: physician, do no harm -- which you didn't. I'm sure the patient understood. You can't live your life saying shoulda, woulda, coulda every day of your professional life.

That's why you are such an excellent physician. You care. (And, so do we.)

Stomper Girl said...

I understand and empathise fully with the way you are lashing and doubting yourself over this, but as John Cowart put it, your back-up system saved the day. Yours. The one you have. Organised by the same brain that muddled you in the first place. I think your other patients are pretty safe.

My Mister Fixit nearly died because lots of doctors missed the symptoms of his PEs, and we were so lucky to have one who having missed it the first time heard alarm bells in the back of his brain a week or so later.

Cheer up lovely Jelly xx

Blue Mountains Mary said...

Well others have said it so well really.

(I do empathise though. It was my fear of making a mistake that ultimately led me to quit the law - I couldn't stand the anxiety!)

I am pretty confident that the letting go process is well under way with you.

Sleep easy knowing you are very good at what you do - truly.

freefalling said...

"In the end, I can do nothing"
but you didn't do nothing - you did plenty!
You fixed your blue.
You feel sufficiently horrified at what you've done to never let it happen again.
And you are not a callous or flippant human being - I'm sure you have beat yourself up enough.
Yeah - you did do wrong by a patient - but there was no malice or ill intent in your actions.
You gotta forgive yourself, otherwise you'll go a little bit crazy.

Once when Vince was in hospital for his canker rot of the brain, having a transplant - he was given an overdose of morphine!
Now - he was in THE best hospital - Peter Mac Cancer Center, and had THE most wonderful specialist nurse looking after him but she just made a miscalculation.
Her mistake was picked up and they gave Vince Narcan to reverse the effects and he didn't cark it.
She felt soooooo bad and we felt terribly sorry for her. It was a mistake - we all make them.
You are asking the impossible if you expect yourself to be perfect.
Perfect people do not exist.
Okay?
Okay then.

Remiman said...

Jellyhead,
You could quit.
But you're not a quiter, are you?
You can continue to take stock daily and resolve to be more vigilant.
When you stop being compassionate with others you can stop being compassionate with yourself.
{{hugs}}
Condider this a commiseration.
rel

thisisme said...

I don't think I can say much that others haven't said.

Yes, you made a mistake. Yes, being human doesn't make it better. Or easier to live with.

But, and it is a big but, you built in a follow up system. And you followed it.

I know you care. I wish everyone had a GP like you. Don't spend all your time beating yourself up - you cannot focus on the past.

Susan said...

Wow, do you mean to say that you don't have the God-like complex that doctors do here in the USA? They do no wrong, and if they ever did, they certainly would not admit it. (sorry about the attitude, worked with too many docs over the years)

If you get the television show 'House' you should watch it, they are wrong so many times during just one episode that watching it would make you feel GREAT!

Isabelle said...

Jellyhead, I would so much rather have you as a doctor than the most infallible machine. You're lovely, you're funny and you're caring. And reflective, which is what made you realise your mistake.

Just let that gossamer float away...

TUFFENUF said...

When I read your posts, I always wish that you were my doctor with your wonderful caring attitude. So many doctors I have met have a god complex, and just take no notice when a mistake is made, or just blame it on something or someone else. Your worrying so much about this is a credit to your character. Easy on yourself, Jelly, stress kills!

mackey said...

Your heart is as big as the world. I don't have to meet you in person to know that. Those big hearts always make the best doctors.....wish my doc was more like you.
"Mistakes" however disguised are part of life...even for doctors. I understand that you have more on the line than most others but that does not make you immune to our mortal ways. Don't be so hard on yourself...you are GREAT Jelly!

Puss-in-Boots said...

The one thing I got from this Jelly, is that you had the guts to admit your mistake. Many people wouldn't have, but you did. Therefore, I'm sure your patient was very grateful for the eventful outcome.

Be kind to yourself, Jelly. Hugs.

Heidi said...

The thing I think is great is that you went back to the patient and made things right.

Yes, you expect perfection from yourself and you may think that your patients expect perfection... well, they DO expect expertise and knowledge... but most of all they will TRUST you when you are honest and trying your best. What a feeling to know that your doctor is thinking about you AFTER having been in the exam room, too.

Jelly, the doctors that think that they are above correction (even of themselves) or are too arrogant to admit mistake... they are the truly dangerous ones. YOU are a gem!

Hi! I'm Grace said...

Hi, it is my first time here and I just want to say that I enjoyed reading your post.
Have a nice weekend. :)

meggie said...

Oh Jelly. You beautiful person. I feel your pain.
I often look at 'mistakes' & feel we are all so human, so prone to make mistakes... in all sorts of situations, in our lives.
I once made the mistake of assuming a huge truck would stop on a red light, as I made my right turn.
I was wrong.
My children only lived, because I always made them ride in the back seat. This was before seatbelts.
If they had died or been harmed, I would have wished to be dead also.
I always feel the pressure on Doctors, is greater than on others in the community. Perhaps the error rate is more visible, but certainly, it is no greater, & is probably less, than others.
Hugs JellyXXX

Noella said...

It's all been said above, Jelly!

I will just add that I'd feel fully confident having you as my Doctor any day!

A big hug for you... xxx

P.S. You might find it interesting to read a few recent posts on a wonderful blog by an Airline Captain in the USA, whom I admire very much: http://flightlevel390.blogspot.com

Captain Dave is very aware of the weight he carries with his responsibility for his precious cargo!

fifi said...

Don't be so hard on yourself:

You discovered your mistake, and you corrected it.

I would still trust you with MY life.


Word verification: bumsons. I kid you not . lol.

Mimi said...

Just make sure you use a bright marker before your next amputation! :-) I agree with John. I know my doctors have made mistakes and I still trust them. You are wonderful because you are willing to take on such responsibility. Most people just couldn't handle it.

Mimi

Mountain Mama said...

Hi. I found you over at Robyn's, was fascinated with your blog name so had to come for a visit.
Your picture is just beautiful. And how sweet of the lady who sent it.

I scrolled down a bit and saw your lovely pictures of the coast. I have never seen such clear water and pristine beaches. It must be a delight to live in such a beautiful place.

If I had been out walking and saw the copperhead I certainly would have changed my pace.

Cindy said...

Jellyhead, yes being human is hard, but being hard on ourselves is worse, isn't it? It's so difficult to live with those things. When I've done something I know I shouldn't have for hhatever reason -- and I'm not espousing you do this -- but the only thing that works is if I take the time to meditate (and I'm not saying that it works in five minutes) but something about the spiritual process helps me accept, settle down and get out of the knots I've created and finally, move on. Good luck.

Kerri said...

Wow, what a wonderful online support group you've got here, Jelly!
I hope that anxiety you were feeling is as thin as gossamer by now.
This testimony is a tribute to your steadfast and caring nature. We should all be so lucky to have a doctor like you.