Read-a-Thon Hour 1

Hour 1:  2:00AM-3:00AM
Time Read:  45 minutes
Pages Read:  25
Current Read:  The Best of The Best American Science Writing, edited by Jesse Cohen



Editor Jesse Cohen asked the editors of each of the previous decade's annual collections to submit two articles from their collections to include in this collection.  I am still on the first entry, "When Doctors Make Mistakes" by Atul Gawande.  By now most people have heard the horrendous statistics about how many people die each year or whose conditions are made worse by mistakes made by their doctors.  Gawande talks candidly about mistakes he's made in the E.R. and about how mistakes like these are handled.  He asks us to

[c]onsider some other surgical mishaps.  In one, a general surgeon left a large metal instrument in a patient's abdomen, where it tore through the bowel and the wall of the bladder.  In another, a cancer surgeon biopsied the wrong part of a woman's breast and thereby delayed her diagnosis of cancer for months.  A cardiac surgeon skipped a small but key step during a heart-valve operation, thereby killing the patient.  A surgeon saw a man racked with abdominal pain in the emergency room and, without taking a C.T. scan, assumed that the man had a kidney stone; eighteen hours later, a scan showed a rupturing abdominal aortic aneurysm, and the patient died not long afterward.

Shocking, right?  This must have been taken from a collection of the worst stories from around the country.  Or, Gawande "gathered them simply by asking respected surgeons [he knew]--surgeons at top medical schools--to tell [him] about mistakes they had made just in the past year.  Every one of them had a story to tell."

His point is, mistakes aren't just made by bad doctors.  All doctors make mistakes, even good ones, because doctors are people and people make mistakes.  The litigious society that we live in makes it impossible for doctors to communicate open and honestly with their patients, sometimes even with each other.  The one opportunity they do have is the Morbidity and Mortality Conference, or M.&M., which is a weekly discussion that takes place at most academic hospitals.  Every week doctors review what went wrong in their hospitals and what could have been done differently.  These discussions are protected from legal discovery in most states.Gawande discusses the pros and cons of this system and goes on to ask what else can be done to reduce human error.

And that's where I'm at now.  Pretty good stuff so far!  I'm off to a good start with my reading choices.