Showing 61 - 70 of 151 annotations tagged with the keyword "Medical Mistakes"
In How Doctors Think, Jerome Groopman explores clinical decision making with a particular emphasis on the poor communication skills and cognitive errors that often lead to misdiagnosis and inappropriate treatment. He uses a narrative approach, filling the book with compelling stories that illustrate the world of patient-physician interactions. Why did a second doctor quickly conclude that Blanche Begaye suffered from aspirin toxicity, while her first doctor mistakenly diagnosed viral pneumonia? Why did several physicians fail to diagnose Maxine Carlson's ectopic pregnancy until the day it ruptured? Groopman's storytelling skill permits him to convey complex concepts (e.g. availability bias, anchoring, and Ockham's razor) through conversation and narrative.
Three major themes run throughout the book, and each is presented with several variations. The first theme is that doctors who don't listen to their patients are likely to make serious mistakes in diagnosis and treatment. The second is that doctors frequently don't have the self-awareness to understand their own errors, especially those that involve dealing with ambiguity and understanding the importance of emotions. The final theme is that that patients ought to be active participants in their own care. This is not a new message, but Groopman frames it in a new way. Given the complexity of clinical decision making, and the many cognitive errors physicians may fall prey to, patients can improve their own care by helping their doctors minimize or avoid such errors. Among other things this means asking thought-provoking questions like "What else could it be?", "What is the worst thing it could be?," or "Is it possible I have more than one problem?"
Summary:The famed surgeon Douglas Stone flaunts his notorious affair with Lady Sannox, although his professional reputation begins to suffer. One night a mysterious Turk asks him to attend his wife, who has cut her lip on a poisoned dagger. The Turk insists that amputation offers the only hope of recovery. Anxious to pocket the proffered gold, and impatient to get to his mistress, Stone dismisses his professional misgivings. He excises the lower lip of the veiled, drugged woman--only to find that he was tricked into disfiguring Lady Sannox herself. Lord Sannox (disguised as the "Turk") thus gains his revenge, with his wife morally chastised (and forever after in seclusion), and Stone’s "great brain [thenceforth] about as valuable as a cap full of porridge."
Summary:This Japanese horror story is set in a hospital in financial crisis, short of supplies and staff. We see various nurses and doctors struggling with their working conditions. A patient is injured falling out of bed, a nurse practices her IV technique on an unconscious burn patient, a demented woman wanders the hallways talking to apparitions she sees in mirrors. Two events set the central plot in motion: the burn patient dies because of a medication error and those present—Dr Akiba (Koichi Sato) who was responsible and Dr Uozumi (Masanobu Takashima) who was supervising, as well as the nurse who gave the lethal dose and her supervisor—decide to cover up the mistake, and a patient is brought to the ER suffering from a mysterious infection that is liquefying his internal organs.
Please note that in order to properly annotate this novel, the novel's surprise ending will be revealed here. Snowman--who used to be called, Jimmy--is a rare survivor of a dreadful catastrophe that seems to have been both the product and the demise of modern science. He lives in a tree, clad in rags, hiding from relentless heat and hoarding his precarious cache of food and alcohol, while he tries to obliterate consciousness and avoid contact with a peculiar race of beings, the Crakers. Through a series of reminiscences as he makes his way back to where he once worked, Snowman's past slowly advances to meet his future.
The world heated up to be uninhabitable desert and genetic engineering created more problems (and species! [pigoons, rakunks, wolvogs]) than solutions. People became increasingly reliant on artificial environments--both internal and external--while their purveyors--drug and technology firms--held ever greater but unthinking power. The world was divided into two: the rich, safe controlled spaces and the dangerous chaotic realm of the poor. Then an epidemic wiped out most of the human race.
Two friends are central to the story: brilliant but inscrutable Crake whose nerdy gift for science had a role in engineering the 'pure' Crakers and the horrifying world that they occupy; and beautiful, seductive Oryx whose regard of knowing innocence heaps scorn upon messy human desire and emotion. They are the Yin and Yang of the "constructed" world. Only at the end, the reader learns that Oryx was murdered by Crake, who was slain by Snowman. It seems that his arduous journey was simply to destroy the history of the events that he had written and left behind.
Richard Selzer’s memoir is subtitled “A Doctor Comes of Age.” The book is structured around childhood memories, interspersed with stories from more recent times. Selzer’s father, a general practitioner in Troy, New York, serves as the focal point for most of his early memories--a commanding figure of warmth and goodness in his son’s life: “If I have failed to describe father… it is because none of his features did him justice. I should have had to mention wings in order to do that.” (p. 152)
While his father brought science into Selzer’s life, his mother represented the world of art. She was an amateur singer with a “small pure soprano voice” (p. 15), as well as being the doctor’s wife. After the doctor’s death from a massive heart attack when Selzer was 12 years old, his mother had numerous suitors, at least some of whom she eventually married. When he went to college, she began a life-long practice of writing her younger son (Selzer has an older brother William) weekly letters, including such advice as “Rise and flee the reeling faun,” “You do not take enough chances” and “You must learn to be absurd.” (p.227)
Toward the end of Down from Troy, Selzer writes of his parents, “Of all the satisfactions of my life, the greatest is that I have at last fulfilled each of their ambitions.” (p. 251) This is in reference to his having practiced both surgery and writing. He goes on to enumerate the many unexpected similarities between the two professions. The book ends with a narrative that brings together narrative and medicine, the story of a retired surgeon who reaches out to help a young man dying of AIDS.
Dr. Aloysius Lana, a "Black Doctor" of Spanish ancestry, settled in a Lancashire town and courted Miss Frances Morton, a young woman of the local gentry. After he unexpectedly broke off their engagement, he was found dead, and Frances's brother was arrested. At the trial, Dr. Lana himself appeared: the corpse was instead his dissipated twin brother Ernest, dead of a heart attack. Ernest's secret arrival had forced Aloysius to dissolve his engagement, not wishing scandal; Ernest's death allowed Aloysius to create a new identity abroad, his future shattered. But, hearing that the death had been misdiagnosed as murder, Aloysius explained the situation, and he and the Mortons were reunited.
This fine collection of short memoirs and stories by doctors offers a variety of narratives about memorable moments in medical education and practice that raise and explore practical and ethical issues in medicine. An explicit aim of the editors was to focus on some of the rewards in medical life as well as the struggles it entails--those often being inseparable.
Starting with a section on medicine and poetry which includes memories of William Carlos Williams by two of his well-known students, Robert Coles and John Stone, and a reflection on illness in poetry by Rafael Campo, the collection is then divided into two major sections: "Grand Perspectives" and "Intimate Experiences." The former includes narratives that show the development of practices, conflicts, or learning over time spent in hospitals and clinics, observing the careers of elders in the profession or the parade of patients whose expectations and needs stretch the physician's creative resources. Several, including Perri Klass and David Hilfiker write about particular patients whose cases became personal landmarks.
In the latter section, stories focus on single cases or incidents in the lives of doctors, some humorous, some tragic, some bemusing, all attesting to the chronic ambiguities of the work of healing and to the very human tensions that arise in institutions that both enable and inhibit the compassion all good doctors want to exercise.
The setting is the children's ward of a hospital in Paterson, N.J. during the Great Depression. Alternating between a cynicism born of desperation, and empathetic concern, the physician-narrator describes the sorry condition of his young patients, virtually abandoned by their parents. He muses that they would be better off left untreated so that they would not have to live the inevitably wretched lives ahead of them.
One child in particular has captured his attention. She is Jean Beicke, an eleven month old, malnourished, deformed girl suffering acutely from broncho-pneumonia. The nurses and he look after her, and she responds to their care by taking nourishment and gaining weight. This is tremendously rewarding and reinforces their interest in her, but to their consternation she continues to be very ill. "We did everything we knew how to do except the right thing." "Anyhow she died." The benumbed mother is persuaded to allow an autopsy; the physician wants to understand what went wrong although he "never can quite get used to an autopsy."
The postmortem uncovers an infection of the mastoid process which has spread to the brain. The narrator and the "ear man" berate themselves for having failed to take proper steps to identify and treat the infection. In the end, however, the physician is still unable to resolve the dilemma of wanting passionately to have saved his patient's life, and knowing that the life saved would have been one of misery.
In this tale, Selzer juxtaposes the wealthy chair of the Department of Radiation Therapy, Dr. Arnoldo Cherubini, with Luis Figueira, a scavenger of refuse in the teeming Brazilian city they both call home. Cherubini lives in splendor in the wealthy hillside district, while Luis lives in a ramshackle hut by the sprawling municipal dump. What brings the two together is the discovery by Luis of discarded cesium, which had been inadvertently left in an "outmoded" x-ray machine taken to the dump.
Luis believes his discovery to be miraculous--a piece of a star. He buries his treasure each night, only to uncover and behold it the next evening. Fearing that the guards at the dump will steal his prize, Luis takes it to the home he shares with his sister and her family.
Soon, his avaricious brother-in-law finds the treasure and greedily sells pieces of it to the local slum-dwellers. Luis, with hands rotting, eventually seeks, but then refuses medical attention from Dr. Cherubini. The doctor makes a few half-hearted efforts to aid his patient, but returns to his insular world. Luis returns to the dump and dies shortly after in the arms of his lover.
Sarah (Whoopi Goldberg) is an African-American woman who runs a bookstore, the "African Queen," in San Francisco. She has an adolescent daughter, Zora (Nia Long), conceived with donor sperm after the death of Sarah's husband, Charlie. Zora believes she is Charlie's daughter until she discovers a discrepancy while learning about blood types in biology class. Sarah tells Zora about her conception and Zora, determined to find out the identity of her "real father," breaks into the computer records of the California Cryobank.
She discovers the name of the sperm donor, Halbert Jackson, and tracks him down, discovering that he is a white truck salesman (Ted Danson). She and Sarah are both horrified (Sarah had requested the sperm of a black man), as is Hal, but after some comic conflict, Sarah and Hal fall in love and Zora begins to think of Hal as her father. They then learn that there was a mix up in the records and Hal is NOT after all Zora's genetic father, but by this point they have nonetheless become a family.