Mistakes

Occasionally a flesh-creeping memory bubbles to the surface, or one that makes me cringe with shame or embarrassment.  Sometimes I recall medical mistakes, errors of judgement, sins of omission and sins of commission.  Most are little things and mostly I believe I learnt from my mistakes, didn't make the same mistake a second time.  I told the sad story of what I regard as my worst sin of omission, my failure to recognize, receive and react to distress signals transmitted on an unconventional wavelength, in a post on this blog about a patient I called Peter Szas whose suicide I have always thought would not have happened if I had been more perceptive. had more empathy, more experience (See "Missed signals," February 12 2012).  All young doctors make mistakes due to inexperience. One day a patient who happened to be a personal friend hit his thumb rather than the tack he was vigorously hammering. I drained the painful blood clot under his thumbnail. But I didn't Xray his thumb, didn't discover the crush fracture of the bone below his thumbnail. The hole I bored into his thumbnail to relieve the pressure from the blood clot converted that closed fracture into a compound fracture, the crushed bone got infected, eventually had to be amputated and he lost the extremely important and useful terminal bone, joint, nail, pad of skin and its nerve endings, all the features that make the terminal joint of human thumbs so valuable to us. If such a calamity happened in these litigious times rather than in 1955, he might have sued me for malpractice, and would probably win. I never made that mistake again, and the lesson I learnt from it became an example in one of my regular tutorials with medical students.

Once I slapped an obnoxious little girl, in front of her mother too, to try to make her behave so I could listen to her heart and lungs and look at her throat. Oh, I'd tried everything else first and I had her mother's agreement - her mother told me to do it in fact - and it worked, the little brat shut up; but it would be a criminal offence if I were to do this now.  What's more important, I'm sure it would have been unnecessary if I'd been more experienced, had more arrows in my quiver, at that time. Kneeling at her level and whispering to her, for instance, might have worked.

In a later phase life as chairman of the curriculum committee, I presented to faculty council a proposal for some common-sense fine tuning of teaching time allocated to various subjects.  I had neglected to consult in advance with a few department chairmen whose teaching hours would expand or contract by an hour or so each year as a result of this eminently sensible change in the curriculum.  It was the most angry, acrimonious meeting ever.  I had overlooked a vitally important fact: department chairmen, especially those who feel a trifle insecure, have an attitude towards allocated teaching time (measured in minutes, not hours!) resembling that of mediaeval barons and dukes to their fiefdoms. I learnt never to present proposals to colleagues in a manner that may come as a nasty surprise.

I am a lousy public speaker.  I think I've improved gradually over the years but reflecting even on some relatively recent performances, I shudder with shame at the recollection of times when I rambled off topic, digressing from my written text into a boring in-group anecdote, or made a feeble joke based on a play on words. I've always been fond of making a play on words, often a kind of pun. I did it at school once, with very painful results: my play in words made use of the names of half a dozen prefects. I was summoned to their sanctum, commanded to apologize, but was so terrified and intimidated I had no idea what I had done wrong, and when I asked, the head prefect was so enraged he gave me an extra "six of the best" on top of the prescribed four for my crime of disrespect for authority. I don't think I learnt anything useful from the experience but I carried the bruises from the beating on my backside for several weeks.

Ah well.  No doubt all of us could do better if we had a second go around the track.