My turn: Of doctors and their mishaps

Posted: Wednesday, May 28, 2008

Nothing in this world is perfect. Bridges fall down, trains collide and airplanes fall out of the sky. Many of these events are due to human error - others are unavoidable. Death is inevitable.

Doctors are not exempt from making mistakes and experiencing mishaps. In my long medical career, I have not known a single doctor who is infallible. The good ones readily admit this even though insurance companies tell them not to. The bad ones never make a mistake and claim infallibility. They are the ones to avoid.

This is what I tell my students. A story in the New York Times of May 18 tells of a famous cancer surgeon in Chicago who did an excisional biopsy on a rib and removed the wrong one. When he recognized his mistake, he went to the patient to explain what happened; expressing his deep regrets. This was accepted by the patient, the hospital paid for her discomfort with an agreed moderate sum and funded the second surgical procedure. Good will was maintained and attorneys were not required.

This reminded me of several mistakes that I had made in my long career, first as a young internist in Juneau and later abroad in U.S. government service. However, one event years ago still stands out like yesterday in my memory.

I had seen the wife of a senior American diplomat who was referred to Bangkok from a neighboring country for medical evaluation. She had pain in her arm along with muscle weakness and wasting. I referred her to a local hospital and asked my Thai university staff neurosurgical colleague to see her. Imaging studies revealed a severe prolapsed cervical spine disk which needed removal. This routine procedure was done.

The next morning, my colleague called me and told me to please see the patient with him as there was a problem. He explained that he recognized after surgery that he had taken out a normal disk next to the prolapsed one. This surgery is done from the front via a sort of "narrow tunnel."

Sweating, I asked what he intended to do.

"Of course I will have to explain this to the patient and would like you to be present as you are the referring doctor," he said.

This we did and he offered the patient to have the procedure repeated by an other qualified surgeon or give her the records to have it done in the U.S. at a center of her choosing. They wanted to think about this and we had a very tense lunch.

When we came back, patient and husband stated that they were impressed by his honesty and wanted him to repeat the surgery himself as soon as possible. All went well after that and we, as well as other western embassies and Thai patients, continue to use this doctor extensively to this date.

It troubles me now to come home every summer and see the change in American medicine, having been among the most professional and technically best in the world, to become a business and a contest between competing doctors, patients, attorneys and advertising agencies.

Unfortunately, this trend is also expanding to much of the world. The story in the New York Times should be widely read by physicians, hospital administrators and the public everywhere.

• Henry Wilde is a professor of medicine for Chulalongkorn University in Bangkok. He is a longtime Juneau resident.

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