Pressing the reset button

A flurry of faces, information, challenges and thoughts have accompanied the start of Telluride East 2014.  Several issues were discussed, all equally valid and important, but one occurred early and stands above the rest.  It set the tone for the rest of the day as its message remains the proverbial yoke weighing on our shoulders – the impact of ignoring the human element in the face of error.  We can’t just press the reset button once an error is made, but we can reset our perspectives on the best way to mitigate, manage and cope with the error, or even the potential for error. So why reset the perspective?  Well, it’s due to an unanticipated emotional response that led me to wonder (in text-speak) WTF?  Lewis Blackman’s story, although tragic and emotionally charged, led to a slew of responses, one of which that left me feeling guilty.  That was the knee-jerk reaction of relief.  Relief flooded my mind as I revisited the last time I personally faced a scenario that could have led to a tragedy like Lewis’.  But it didn’t, and I attribute that partially to the network I had at the time.  It was relief that I had a leg-up on protecting my family when in need due solely to the fact that I knew someone.  A simple phone call connected the frightened, stressed, and overwhelmed patients with an advocate patients so desperately needed at the time.  And for that I felt guilty – privileged and grateful – but guilty.  Why should I of all people have the ability to protect my family more effectively than others?  Why should I even have to worry about that scenario?  It is these questions that identify the need to reset the perspective. Errors happen.  We are human, systems do not remedy themselves overnight, and medicine is a high-stress, high-risk endeavor.  But involving the patients, empowering them even, allows for the re-introduction of a key element to the doctor-patient interaction.  This element is so important yet often overlooked; it is the element of humanity.  The human element demands respect, empathy, communication, and understanding.  It seems so intuitive yet reports on these cases consistently identify such basic human elements to be lacking.  Several reasons can be argued as the source of this dearth, but nonetheless it should be reintroduced as a focus.  Considering the patient as we would our own family, involving the patient in the treatment process, providing the alternatives and associated risks during informed consent, apologizing and admitting a mistake – these are all behaviors that acknowledge and enliven the interaction between patient and physician.  It builds relationships and trust.  It changes the course of outcomes.  So perhaps it is important to reset our mentality and focus on a simple, yet important component to which we all can relate – being human and the needs and desires that condition requires.  
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