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To begin: how do mistakes
happen in the first place?
"Sicker patients have many
more treatments... than the average person," she says, and
"the sheer number of moving parts... nearly guarantees that
there'll be at least one thing... that doesn't go as
planned."
Electronic medical
record-keeping can be a reason for mistakes. If medical
personnel are not given ample time to think, simple human
error can cause missteps. Being too careful and
experiencing alarm fatigue can both be surprisingly large
problems. Diagnostic tests can give wrong answers or yield
too much information; short-staffing can be a big issue; and
racism happens, even if someone has no outward bias.
But, there's good news:
nurses are empowered now more than ever before, as are
patients. Instituting checklists has also helped in many
places, such as operating rooms. Interns and residents are
no longer required to work long hours with no sleep, and
medical knowledge gets better every day.
So what can the average
patient do to lessen the chances of being on the wrong side
of an error? Pay attention to your nurses, says Ofri; they
are front-line personnel. Know your medical history. Demand
your doctor's undivided attention at medical appointments
and know what questions to ask. Bring someone with you, if
you can. And look overseas at Denmark – they have one key
thing figured out.
Admit it: at some time in
the past weeks, the thought of illness has entered your mind
a time or two. This book will give you a lot more to think
about.
Don't think that When
We Do Harm is a lot of blame-passing, though. By
considering all possibilities and holding a mistake of her
own up for examination and castigation throughout this book,
author Danielle Ofri offers not excuses but reasons
for why things go wrong in a medical setting, which could
help medically-minded readers to feel better and do
better. Don't rest, either: later chapters dive back into
reality by discussing the elephant in the room, which is the
possibility of malpractice lawsuits. These two sides balance
this book nicely, even before further underscoring drives
home the points Ofri makes as she shares two major,
dry-mouthed and heartbreaking story-arcs that are
illustrative, impactful, relevant, and downright painful.
Not just for medical
personnel, When We Do Harm is accessible for anyone
who is or has ever been a patient. It's neutral, thoughtful,
insightful, it reads like a thriller that's narrated, and
that's pretty wonderful.
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