M&M last week was scary. Scary as in, I don’t let myself say, I would never have made that obvious of a mistake. Instead I say, someday I will be the one to make that mistake, so I better watch out.
No details at all, just the lessons I got:
Never believe anyone. Verify everything for yourself. Seriously, not just an axiom.
Look at all xrays as a matter of course. In addition, I must personally look at every CT done on every patient I’m caring for (let’s say done within the last week), regardless of whether radiology has read it, and regardless of whether other surgeons have told me it’s ok.
Every CT, slowly, head to toe. Then on lung windows, head to toe again, slowly (this is a different penetration view of the CT, to show lung findings, abdominal findings in a new light, and check for free air).
If a patient feels like they’re doing badly, start from scratch and look through the whole story again for yourself.
I’ve gotten through the first week of nights without any major disasters. That isn’t a good thing; that means they’re still out there, waiting for me. . .
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Of course that isn’t true – on another level. Of course I said I’ll never be the one to make that awful of a mistake. It’s a game of roulette: if I concentrate hard enough, maybe I can make it through; as though will-power can bend chance, or concentration will never fail. . . but if we didn’t all think there was a chance we could try hard enough to not make the mistakes, we would have to stop right now.
November 10, 2009 at 3:17 pm
Hi!i just came across ur blog and just to say i love your stuff.i am actually at a point where i am trying to decide if i really want to be a surgeon(4th year med school with 2 more years to go)i LOVE surgery and reading your blog is giving me some interesting insights.i am still wondering what family life would be like for woman though.Thats kinda important to me too.plus its great to know you are a christian too.so keep blogging,you’ve got one more person who loves what you write, even though i have a lot of catching up to do and since i love to read anyway am off to read you past(older)entries.
November 10, 2009 at 6:44 pm
General surgery intern here—this post reminded me of something a chief resident told me while on my 4th year AI. “Imagine that everyone is a ninja assassin trying to take out your patient… nurses, other residents…and you’re the one trying to save them. I laughed at the time, but have quickly realized the truth in the statement.
I try to remember that on when now I’m the one taking the calls on the patients. I really have enjoyed reading your experiences, and I appreciate you chronicling your journey–I know-all to well-how limited your free time may be. Take care. -k
November 29, 2009 at 2:27 pm
So true. This is something scientists need to remember, but often don’t. We try to rely on each other as a shorthand, but in reality it can be very dangerous to do that. Still, sometimes you can’t- you can’t always be questioning if the X-rays are imaging correctly, for example. But vigilance is always good. And never thinking you’re too good to make a mistake yourself.