2012.10.15 07:56
Blood on My Hands In this business blood on the hands as long as they're gloved isn't a bad thing. In fact, it's expected— part of the job. I made a mistake. I let his unassisted breathing compensate for his blood for far too long. Now I’m trying to compensate for my failure with ventilator, pressors, a hasty central line in a patient Trendelenburg—slipping away, a course I can't reverse. Then a single drop of blood on the mesh of my right sneaker. I see it while it's still red. For weeks I'll take note each time I look down until it fades among other less incriminating stains. I don't change shoes or try to wash them. I wouldn't dare. Adam Possner, MD |
2012.10.15 08:20
2012.10.15 10:32
A Chilling story (or a poem?). Cold sweats seem to run on my own back !!
I feel exactly what the writer felt. A darn realistic poem, this is.
Is he kidding me? For such a serious problem, can a stuff like this be written as a poem?
A nightmare of all of us who work in the operating room.
I am glad it was over for me long time ago.
His writing sounds like a story of an anesthesiologist, rather than a surgeon.
A surgeon seldom wear sneakers. Whatever shoes he wears, it is covered.
The blood is not going to fall on the shoe-meshes.
Why bother with central line and vasopressor,
when the priority is paying attention to the ventilator that was the original cause of this mishap?
The others can be done by other people nearby.
Where did the drop of blood came from to land on his sneaker?
Is this a poetic intervention?
Anyway, I am glad I was not a part of the room where this happened.
I am glad that I won't be a part of the room where things like this can happen.
2012.10.15 12:11
2012.10.15 15:48
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This poem is from this week's JAMA, October 10, 2012,
in the section of "Poetry and Medicine."
I have no idea who Dr. Adam Possner is.
Likely he is a surgeon. Or possibly he could be a cardiologist like myself who is doing lots of
procedures on patients having threatening or actual heart attacks as I was for some thirty years.
Whatever his specialty is, by reading his poem I can feel his pain or sympathize with his pain,
the pang of conscience losing a patient, especially
if indeed the patient had died because of his mistake in clinical judgement.
This is indeed one of fundamental issues or should be for every physician.
If a doctor does not feel the pang of conscience when he causes any harm or injury
because of his or her mistake, that doctor becomes a very dangerous doctor for the patients and
the public.
This subject was something that I used to have to deal with when I was in charge for
quality assessment for a dozen of invasive cardiologists at our institution.
We had a cardiologist who had an unusually high complication rate including deaths,
and I observed him closely and was concerned enough about this question.
I had a serious discussion with his senior partner and asked him specifically on this question, I remember.
"Does he show any sign of remorse, any sign of pang of conscience when his patient developed
the complication partly because of his poor clinical judgement ?"
This Doctor Possner must've felt pretty bad and apparently had to write this poem.
I rearranged the words a little so that we can read more smoothly.