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So many lawyers, so little time...

"The prospect of hanging focuses the mind wonderfully"--Samuel Johnson

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Location: Louisville, KY, United States

Gastroenterologist, cyclist, cellist, Christian, husband, father, grandfather.

Saturday, February 12, 2005


As a member of the Christian Medical & Dental Associations I have access to the Medical Malpractice Ministry.The ministry is headed by a very kind woman who prays for you and all parties involved with the occurrence. She also puts you on a waiting list for a tape series about "How to Survive Malpractice Suits".

Over the past few years the waiting list for the tapes has been pretty long. It took me three or four weeks to receive the material, such is the demand for it.

The tapes do not let the listener indulge in self-pity; it challenges us to take responsibility for our own actions and to forgive the actions of others against us.

One quote startled me: "For every malpractice suit one receives, he's probably guilty of ten to twelve occurrences that could have led to a suit but didn't". That means I've been guilty of as many as thirty-six instances of malpractice. That's a lot.

To my knowledge I've never committed a Res Ipsa Loquitur, such as removing the wrong body part. We've all had cases where we look back and ask, "Man, what were you thinking?", situations where we made poor judgments, overlooked clinical clues, and the like.

I once missed the diagnosis of acute mesenteric ischemia. Although the patient's presentation was confusing and other doctors were fooled as well, I hold myself to the highest standards of practice. It's not clear the patient would have survived (he probably wouldn't have), but without an accurate diagnosis he had no chance at all.

About a week after the patient's demise I met with the patient's family. I explained about the cause of death, our failure to make the diagnosis prior to death, and my opinion that it may not have made much difference under the circumstances. The family appreciated my candor.

As penance I shut myself in the hospital library for one afternoon, reading everything I could get hold of regarding acute mesenteric ischemia. I resolved that I would never miss another.

Since that time I've seen other presentations of acute mesenteric ischemia, presentations that had baffled every other doctor. I've never again missed the diagnosis. I'm proud of it. But remembering just how I acquired this expertise is always bittersweet, my perpetual memorial to the patient who died that I might develop good judgment.


Anonymous Urska said...

happy valentines day! no new posts, huh?

2:50 PM  
Blogger Gorilla said...

Good for you!!

11:34 PM  
Blogger JusPasenThru said...

My internet activities were interrupted by a brief encounter with the real world. It won't happen again!

1:41 PM  
Anonymous Halram Augustine said...

"I have a lot of arrows in my quiver, but most of them I've had to pull out of my bloody back !"

My field is computer fixit, so no patients were harmed, but a lot of my own and my clients' patience was used up. :)

Quote by Douglas Keachie

2:59 PM  
Blogger ndm said...

I lost my mother to a misdiagnosis of mesenteric ischemia. I do believe that it was not mesenteric ischemia that ultimately killed her...as the operation to re-establish blood flow to the gut was a success and there was no presence of necrosis. I do believe that the delay in diagnosing her leaving her severely malnutritioned (from 140lbs to 79lbs in five months and severe muscle atrophy) was what ultimately left her unable to recover. After reading your article... I wish that it was you that had misdiagnosed my mother because atleast I would have had an honest approach to the situation and would have known that some good would have come from her situation. I commend you for your honesty and your ability to learn from your mistakes. So often our egos prevent us from acknowledging what will only make us stronger and more intelligent in the future. I was touched by your posting.

10:46 AM  
Blogger JusPasenThru said...

Thank you. We'd all be better if we could admit to being wrong every now and then.

Just not during a deposition.

3:31 PM  

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