Puttering Around the ER

Ah, to kill the clutter. There's nothing like a visit from a phone/cable/satellite/internet/exterminator guy -- anytime between the hours of noon and four -- to spur a little sprucing up around the abode.

Mel calls it "puttering." I don't know why exactly. She tells the kids we're not going to do major housecleaning, we're just going to "putter." I think the kids generally interpret that as, "we're going to keep cleaning until Mom is bored."

So, we puttered today (and yesterday, Thursday, and last Friday, too, but that's a different rant) in anticipation of the internet/phone/TV guy showing up and tromping around the house in his little paper shoe covers installing the new combo internet/phone/TV thingy.

He sort of showed up, but not really (again, that's for another rant on another day and I'll explain how puttering ended up with me at La Morenita's, my favorite Mexican restaurant, having a grande margarita and drowning my sorrows in chips and salsa).

What did happen is a gloriously clean office devoid of clutter thanks to the putter. Of the twelve thousand (give or take) pages of incident reports, paramedic student evaluations, old faculty contracts, EKG strips, dispatch data and other banal paperwork Mel had me sorting through I came across a copy of an incident report I wrote concerning a patient I delivered alive but who did not survive.

In my not-so-humble opinion I felt the care this patient received at the ER contributed to her early demise (which is exactly how I wrote it in the incident report -- an indicator to me that I was pretty damn pissed off at the time). The full story -- minus names and such since things like medical error can be so litiguously touchy -- will be in some future book, but today I was simply sad that mistakes like the one I witnessed can just slide on by.

The doc isn't one I would ever have counted as a star in the medical field. It's like the old joke: what do you call the person who graduates last in the class at medical school? Doctor.

No, this particular MD is mediocre at best, and the mistake in question was the kind of stupid error that mediocre docs (and to be fair, mediocre paramedics) make when their mediocrity is offset by the confidence that comes with their license to practice medicine, which too often becomes a license to kill.

I've made mistakes in my career. Still do -- all the time. I've probably even killed someone from a mistake I've made, and worse yet, couldn't tell you when it happened because I never realized my erroneous action and therefore will never learn from whatever it was I did that was wrong.

That's the issue in this case. This doc is never going to understand that there was a mistake and that the mistake led to the demise of the patient (or at least greased the skids a little). I hope that if I have made a mistake like that, that it was no more than once and that I will someday understand my error.

I tried to make a stink after it happened, but how exactly does a paramedic rat out a doctor for a medical decision? It's not like seeing a doc practicing medicine drunk after a 3 martini lunch. That's an easy one.

No, this is more like the drafting student telling the master architect that his design isn't safe. The architect is going to tell the student to mind his own business and let the architect draw the plans. Who was going to listen to the medic about the bad doctor?

Worse yet, the doc was pulling quality assurance duty that quarter. When there was a question about the clinical practice of a physician in that ER during that time, this was the doc who had the responsibility to investigate it. So a complaint about clinical care would go to the very doc the complaint was about.

A physician friend, whom I have great respect for, pulled me aside and suggested that I drop the issue. He assured me that the doc in question would never face discipline for the mistake, despite the fact that my physician mentor wholeheartedly agreed with me.

So, despite the fact that I had puttered for nearly three weeks, this particular bit of housekeeping never got finished and the clutter remains to this day. I'm just waiting for the next colossal blunder (hopefully, it won't be mine).

Docs, nurses, medics, respiratory therapists, EMT's, we're all human. We're going to screw up. If anyone on that list screws the pooch (remind me to look that term up) except for the docs, he or she will pay for it. Docs, on the other hand, only have other docs to watch over them, and doctors are a protective lot.

Until there is a new way to hold doctors accountable for their mistakes, I guess we'll all just worry about our own care and try to steer the docs in the right direction if we think they're veering off the path.

Or I can go be an internet/phone/TV guy. I don't have to do anything, then.