by Janice Park
This probably isn’t the normal sentiment to hearing John Nance speak. He gave us an incredible talk about patient safety and summarized many of the important points he made in his book, Why Hospitals Should Fly. He told us stories about hardened surgeons and flight disasters, explained why our system cannot function the way it does. But as he spoke to us today, I couldn’t help but experience this enormous wave of relief.
Why? Here is an experienced pilot explaining to a room full of residents, medical students, and nurses that the way we practice medicine is unsafe because it relies on every single one of us to act in individual perfection, which is humanly impossible. He asked us whether any one of us had ever been taught that we are allowed to be imperfect, and no one raised a hand. This entire model of thinking is entirely flawed. Humans are inherently imperfect.
Something that has been nagging at the back of my mind, pretty much ever since I started considering medical school, is the fear that I will harm or kill a patient. I’ve heard the horror stories residents and attendings tell—those patients they will carry with them forever. I can’t possibly imagine that burden, that feeling of being the physician responsible for a patient’s death, or irreparable harm. But I feel it coming in my career, and I desperately want to stop it.
And here, today, I feel like John Nance has given me permission to understand that yes, I am an imperfect carbon-based unit. I may work to the absolute best of my ability and use all of my brain and willpower and still fall short of catching a fatal error, because I am human, and I make mistakes. Every individual in a team is imperfect, but if we work as a “collegial interactive team” while being patient-centered, we can optimize our overall function and outcomes. We can strive to hit zero: zero mistakes, zero fatalities, zero harms done to our patients.
It is a relief to know that it is okay to be an imperfect person who is a practicing physician. I mean, of course I will be an imperfect person—how is it possible to be anything otherwise? It is a relief to know that that doesn’t make me a bad person, or even a bad (future) doctor. It is a relief to me that I can learn to be the kind of team leader who fosters an environment where my colleagues will catch my mistakes and speak up. It is a relief to think that I can rely on others despite my failings—or perhaps, more accurately, because of my failings. Of course, I will still strive to be the best I can possibly be by working hard and being honest and continually learning from my patients. But how freeing would it be, as a leader and a care-giver, to create and nurture the kind of team that works seamlessly with me to provide the best possible care for our patients?