c.2020, Beacon Press
You felt wonderful.
Never better. In the peak of health, fit as a fiddle — until you weren’t. Then you were achy, miserable, feverish, nauseous. Blame a virus, but is that the case? Or, as in the new book “When We Do Harm” by Danielle Ofri, is modern medicine the culprit?
In 1999, the Institute of Medicine released a shocking report claiming that up to 98,000 patients die each year in the U.S. from medical errors. Wondering if that’s high, low, or spot-on, Ofri, a physician at New York’s Bellevue Hospital, decided to “get to the bottom of this.”
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.