So far, I've only managed to have two posts per month in 2023. I'd like be able to do better than that in April. I won this book through a Goodreads Giveaway and I completely forgot that this was the source of my copy until I looked at the source of my copy on Goodreads. I'm grateful to the publisher for providing me with a copy for review. I'm sorry that's it's taken me so long to read and review it.
Dr. Ofri quotes a Harvard study stating that errors were usually the failure of computerized record keeping systems rather than individuals. It seemed to me that this was much worse because the record keeping systems are pervasive in institutions.
I've read about Ignaz Semmelweis (1818-1865) elsewhere. He is credited with being the first to advocate that physicians wash their hands with chlorinated lime solutions before touching patients. Another pioneer, Joseph Lister (1827-1912) is credited with antiseptic surgery utilizing carbolic acid to sterilize instruments. Both Semmelweis and Lister are honored today, but during his lifetime Semmelweis was ridiculed. I found out from Ofri that Semmelweis died tragically of beatings by the guards in a mental institution.
Ofri discusses unnecessary alerts sent by the system. One example was that drug interactions weren't available for the walker she was prescribing. It occurs to me that if doctors had AIs capable of learning, that sort of thing wouldn't happen. Yet that would be very expensive.
Ofri also gets very necessary alerts about medications being contraindicated for certain conditions or the need to dose certain medications differently. Unfortunately, Ofri gets so many alerts that are useless to her that she ends up ignoring all of them. This is a source of medical errors.
In a discussion of medical history, Ofri brings up the possibility that Van Gogh was taking digitalis derived from the foxglove plant. He painted his doctor holding the bell shaped foxglove flower. (See an article called "Creativity and chronic disease Vincent Van Gogh" from The Western Journal of Medicine here, and an article from the UK Guardian on Van Gogh and digitalis here.
Below is a public domain image of the Van Gogh painting of Dr. Paul Gachet, Van Gogh's physician, holding foxglove.
Toward the end of this book Ofri discussed patients who die from multiple causes with a colleague. Death certificates only allow for a single cause of death. The colleague thought that death certificates should permit the listing of a preventable complication that contributed to the death. This would allow medical errors that hastened death to be included.
Ofri closes with the famous quote from Hippocrates that the goal of medicine is "at least to do no harm".
I feel that informing us about the frequency of medical errors through When We Do Harm is important and beneficial. We need to know that the practice of medicine is far from perfect despite the best intentions of medical professionals.
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