Doctors make mistakes. There; I’ve said it. For those of us in the profession, that can be a hard pill to swallow, but the earlier that lesson is learnt the better, not only for our patients but also for ourselves.
Doctors make mistakes – the important question is, can we admit that? And how do we deal with it?
I read with interest last weeks blog post on the @re-humanising website: Remembering examples of humility. The author asks if humility is a trait that is developed over time – whether we, as health care professionals travelling along the road that is our career, witnessing the suffering that we do, and making the mistakes that we will undoubtedly make, develop the deepening humility that is often witnessed in those in the later years of their careers. I’ve no doubt that this is the case. And this leads me to question the impact of the these life lessons on the individual; how much suffering can one witness and how many mistakes can one make before the personal impact becomes too much to bare?
We get things wrong. We make unwise decisions, we misjudge the risk, we fail to pick up on clinical signs or disregard symptoms. We listen, but with our ears not truly tuned in. We misinterpret a test result, or fail to spot the pattern that could have led us to the correct conclusion. We are distracted, interrupted, hungry, angry, late or tired. We are often all of these things. We may be unfamiliar with our new work environment, feel intimidated by those around us or maybe have an unconscious (or conscious) prejudice. We are struggling with the demands placed upon us; work demands, personal demands, financial, social, political. In the main we don’t mean to feel and do these things, at least I don’t think we do, but these things happen, with potentially devastating consequences. These are the days when the holes in the Swiss cheese align exactly, and a patient; a person, someones loved one, is harmed as the result of our actions, aided and abetted by a system that doesn’t quite have the safety nets in place to prevent it.
I would love to question those who seem to lack the humility that last week’s author witnessed in the experienced professor. Do they truly lack humility, and if so why? Maybe they are afraid to show the humility they possess deep inside, frightened of the impact of doing so; maybe scared of the negative effect on their careers, concerned about their reputation or terrified that removing the armour surrounding them will give their personal demons the chance to destroy them from the inside out. Maybe they feel that humility has no place in medicine, believing patients need and deserve doctors who tell rather than listen; prescribe rather than consult, command rather than co-construct.
There have been some whom I’ve worked with over the years who I wish I’d asked these questions.
Confident, all knowing, capable, proud.
Cocky, ignorant, incompetent, arrogant.
Tentative, reserved, competent, humble.
How fine the line between these three sets of characteristics, how quickly one can morph to another, and back again, and how often these characteristics become jumbled together. What is the best combination? Do the behaviours we witness always mean the same?
I’ve recently had the honour of listening to the mother tell the story of a young man, her son, who died a few years ago. His complex needs had been poorly managed and both he, and his parents, were not listened to when they repeatedly voiced concerns about the administration of a drug which ultimately led to his death. She told her story to a room packed with healthcare workers of all backgrounds, and for an hour the room was silent, the abundance of downward, tear stained eyes in the audience testimony of the impact of her words. There will be many in the room that day who would have gained the next tick on the humility scale, if one were to exist.
Humility in healthcare develops because of stories, both told and untold. Lived experiences of good and bad, happy and sad, right and wrong. It can’t be taught, there is no eLearning module or journal or blog. But there will always be stories, and the more we share them, the stronger and hopefully more humble we will become.