« Dr. Death

Dr. Fata: How To Spot a Dr. Death | 5

2020-12-30

Imagine you're working at a hospital and you notice something isn't right: what do you do? Season One and Two of Dr Death featured medical professionals who crossed the line. Laura Beil speaks with Dr. Danielle Ofri, author of “When We Do Harm: A Doctor Confronts Medical Error.”

This is an unofficial transcript meant for reference. Accuracy is not guaranteed.
Imagine work in a well respected hospital. You can to your patience. But later you ve seen some things that make you a little uncomfortable. Unlike wait, Wyatt. I said why are you giving them hydrogen if they don't need it? Maybe it's a surgeon who doesn't seem to know what he's doing there were a number of practitioners, Aaron, Dallas, more goin down to them? Taxes, Medical board saying: Ve got a real problem with this neurosurgeon they cannot operate. Actually it doesn't even look like he's trying to operate correctly. It look like he was trying to
on the patients on purpose or a doctor who seemingly makes up how he administers treatments he would just say to european protocol. I can choose the doses that I want, but he's the doktor and his the last say I mean I'm, not gonna. Docilely came all that's not my license. You know that patients could be getting harmed are like being harmed? What you do in that situation, seriously. What would you do? Do I leave now with the others? Do I get to the Department of Justice right now? Do I run over there to the FBI office, or do I just pull a fire alarm to tell everybody to run for their locks? Then who went to Christopher, dense and for Red Fatah trusted their doctors the mating hang was very personal. More, he told me dead didn't treat me right. He would be right there to make sure that I got the proper treatment he was reaching out his hand, turn Vivere person of all, and
clean and hasty now, while you're in the right place. Fatter and dance were doctors. They took an oath to do no harm yet between them. They hurt hundreds of people dance with Scalpel and fought: with his treatment I here, because you destroy my immune system. What am I to my head. He destroyed it. There are people that are dead. There are people that are injured. There are people, there's no winners in this field. It's dad all the way around first and second season of doktor death raised questions about the medical system and the doctors working in it. How were these two doctors, Dutch and fight, able to do so much damage, and Are they able to continue for so long without being start to address these questions, I'm talking with Doktor Daniel O free world.
Talk about how we can keep our trust in the medical system and in the people whose actions can determine whether we live or die. And will ask the question what would you do if you found yourself working side by side with another doctor death? The truth is that it's hard to Until you ve been in there in that situation I can imagine the pressures on people be so vast done. Or death season. Two is pleased to have simply safe as our presenting sponsor there's almost always a rise and break ins during the holidays. That's why it's the perfect time to take advantage of simply safes, huge holiday sale, forty percent off any simply safe system in a free security camera. A system has an arsenal of sensors and cameras that protect every inch of your home. You said
yourself in no time at all, without any tools or wiring, which means no technician or sales person has a step footing your home over the years. I've install my simply safe system three times. If you understand double, stick tape you or a qualified, simply safe installer, then save security, security, specialist monitoring, your home around the clock and ready to send emergency help the moment there's an alarm find out. Why simply safe one one Cnet editors, choice for home security and was named best of twenty twenty by Forbes and popular mechanics, popular mechanics, percent percent, simply safe, plus a free security camera today by visiting simply safe, dotcom, Slash doctor, but hurry. This deal expires on Friday that simply safe com, slash doktor, simply safe dot com, Slash doctor.
From Wondery I'm Laura Bell, and this is doctor death season two. This is so five of five. One thing that is clear from both seasons of doktor death is the doctors, wheeled enormous power and our medical system and with a lot of autonomy. When they're in the room with patients. Their judgment is rarely questioned doctor in season. One and Doktor Fatah and season to both took advantage of that dynamic in their own twisted ways. We now It can be harrowing to listen to these series when at some point were all likely to be patient. Today to understand and hopefully restore some faith and the medical system, I'm talkin, what doktor, Daniel O free she
physician at Bellevue Hospital in New York City, she's, written numerous books on the doctor, patient relationship most recently when we do harm a doctor can France medical error, doktor ovary. Thank you so much for talking with me today. Gave it's a pleasure to be here so star with a question that I get a lot, We be afraid of our doctors. Didn't know, I wouldn't be afraid of doctors. I think that most First and most nurses are there to help you and take care of you and that's why they went to the professions were afraid is be the wrong word. I would still be careful and care gin and have a high index of suspicion for anything that recommended, but but fear I think it's not going to be very helpful. So in your book, when we do harm you talk about how doctors have these near misses. Can you tell me about them
that sinking feeling when you realise that you did something wrong, remorse is something that a good doctor is the post, to feel towards the east, average? Don't even have to be good. I just have to be a human being for goodness sakes, but was second year resident, I was on unqualified interned you, busy night and I got a late mission of altered mental status in an elderly patient. Basically so in a nursing home who looks a bit more defended today, let's admit the patient and I got the report. The patient's totally stable, laps radiology fine, just to get back to a nursing home bed. So I quickly turf the patient. Other service. We have this kind of holding service for patients who is waiting for no home services or nursing home bed or physical therapy, so quickly a pressure, the doctrine and take this patient her service it Patients totally stable labs fire ready occupying yadda, yadda yadda, take the patient and she did
internet. I we high five. We raced back to the idea for a next to no stairwell patient and I learned the next day that the patient, she was bleeding into their brain and that's why they're mental status was altered, but I missed it and I missed it because I didn't look at the cat scan myself. As I knew I should have somebody had said, radiology fine. I just took it on. You know on faith and I was devastated absolute Lord now. The patient in fact didn't suffer any harm because someone also the cat scan corner surgery. The patient was their rights to the war, had the bleed reign, in fact the patient care. Was an impact at all by my error, so we classify that is a near Miss but eyes told me: the error had I discharged the patient home, they may could have been done, So how did that near so You feel I was so devastated that
I didn't tell anyone. I didn't tell my in turn. I didn't tell my suit rising attending and I sure, as Hell, did not till the patient or their family I could not imagine a more horrible fate to drag my sorry sold to the patient's bedside and say I almost killed you and I didn't talk about it for twenty years. That's how awful it was. I couldn't write about it grapple with it and I'm sure that I committed many errors in the weeks that followed my brain was in a fog. My soul was in a fog, so I'm sure I missed many things and committed more errors. I was ready to quit. Two years out of a medical school and I looked back now is a more season physician and I I I can empathize with my younger self. I didn't really understand medical error. I just do that. I was a failure that I hadn't just made a medical error, but I was a medical error and
the danger to patients- and I recognise not that I was overworked- I was you know in assisting the Didn'T- have room for correction error, but also didn't. Allow me to talk about the I am- and I, MR in educational opportunity for learning about that. I miss the chance to help the patient grapple with that all of these things, because the emotions worse devastating and what would have happened if you would have admitted that to the patient and your Superman I don't know it would have been very embarrassing to tell my supervisor No, I really, but this I didn't look at the scan. Someone said it was fine and I believed it didn't check, so I would lose in my supervisors eyes. I might get a terrible recommendation and then telling the patient,
even more horrible. I will tell them what a failure. I am I you trust me with your health and look. I failed you. So no one ever says boy, you really courageous for limiting the error. Congratulations for taking the risk and say up to the plate. All you get is humiliation. Shame you get people thinking! You were ridiculous, offer that traditionally quick go to the pharmaceutical industry or something you get there's nobody. Active to being honest. Now. I definitely want to make a distinction between your near mess, and they Actions of the doctors that I talked about in doctor death there's. Definitely a difference between. Making a mistake and in turn, Elaine doing harm to a patient. I've heard from a lotta listers that the doctors and doktor dad Caused them a lot of anxiety. Oh yes,
listen to those cases was worse just skin curling, because I think you do I I ever met anyone like that in all my years in medicine, I don't think so. I certainly hope not mean mostly who I've met. People who are trying really hard to do the right thing. Do they fall short? Absolutely. Are we imperfect one hundred percent, but I have never come across someone who's been that's or deliberate. To me feels like a psychopath that doesn't feel reflective of the people. I know, and even in the studies of who commits medical errors, the vast majority are committed by carrying committed clinicians who have either have a mistake or a mistake or or made a genuine error, but these were banality or the psychopathy that we see in these two cases, I think, is very different. I mean the thing that really struck me as there is no sense of
of shame and what had happened or feeling terrible. Most physicians and nurses are devastated by medical errors. In fact, there is a case of a nurse in a neonatal intensive care unit care unit. Who was a twenty year veteran by all consecrate nurse who made a tenfold calculation, error and calcium chloride and gave injection and the baby died, and that nurse eventually took her life by suicide. No, we don't know the pieces in between how was handled, but I think all of us in medicine can relate to that feeling. It is so horrible that you have harmed your patient that you feel Since it you should, you should not be there any longer. We identify with that and in fact, medicine has the highest suicide rate of any other, comparable profession, ride I get asked a lot, especially in in these cases like what are you do you think they did this, and in fact this case it was maybe more obvious to me resist greed
Aren't you a little bit harder call to me like why, in a way they do this. Why did me stop I would love to know. To the degree you can your thoughts on as an end compare the mindset of these doctors with a normal doktor, feels when things go wrong which struck me when I was The two series of this podcast was that these weren't just outlier doctors- they were outlying human beings like their false or not medical false. They were psychological, false or psychopathological that is certainly not true. Dunce struck me someone. It had nothing to do with his medical or not? He was a disturbed person who was unable to see what is in or if he could see it continue doing in either case that a deep personality disorder. In my observation with Dr Fata,
I observe someone who allowed agreed to. Override his medical knowledge and principles, but still it seemed like a cycle pathological issue and not a medical issue, so I I didn't judge them so much as doctors, but is flawed people whatever profession, had gone into. They would have caused harm to me. That's different. When I know the doctors who committed or conservation harm, and I can't self in that group, it is devastating even a near Miss the idea that you have somehow harmed a patient mean. There are doctors who quit their doctors, who turn to substance abuse their doctors have committed suicide over this oh devastating, humiliating shameful theirs. I don't know anyone whose unscathed, by that everyone has made errors, whether their able to admit it to themselves or to others. We ve all made errors and its
just its tragic and eaten. Never is a non entity. How often likely you come across a daughter like doktor danger that your father, I think quite rarely, the more common situation would want to doctors, not so good. That's a very hard thing, because it's a shade of gray, but that's it. You know a much more common issue. What do you do with doctors? Who are you know? I once inherited patients from a doctor who had left her institutions working at I started reading the notes. I was shocked at how how thin they were. His person did not do a lot of documentation and I was kind of shock, they ve been there for many years and were respected. Now, if I dont know what their inner thought process were, but why that was really. It was less than a standard of care that that I would do- and you know that kind of thing there's no real recourse for that a new way, and that seems like the more the larger issue is much more common and much
prevalent. I couldn't imagine if you were in the situation, could a new recognise a doctor as really terrible as these two that you would not speak up, although the truth is that it's hard to say until you ve been in there in that situation, and maybe the pressures I don't know, I assume I would, but I can imagine, the pressures on people might be so vast you know, you will never get a job and I'm thinking about the office manager with Dr Sparta. You know the consequence that he faces of he did the right thing and just by association you he suffered consequences and it's it's not. You know unrealistic. So I can see why, but I have some the plea for people who resist that. I think they need to overcome that. I do strongly agree, but I just don't want a judge firstly, because one can unrest made the pressure until once been there and I haven't been there. Thankfully,
these kinds of errors or mistakes, whether their intentional or unintentional, their hearts, to uncover when the person who commit them doesnt work Anyone to know, listen, any human being. Who wants to face up to their errors in public? We we, you automatically instinctively hide from that. So there is no way and then plus you can get sued. If you admit your error in public. So why Would anyone fight the legal malpractice I the emotional side, who's gonna wanna talk up it's very hard to do, even though you know it's the right thing to do and the times that I've done it, it stole the very difficult There's a famous quoth at every doktor carries her own cemetery. The quote is from four Naylor, who was a surgeon from the late eighty, seven, nine nineteen, fifty six, every
virgin carries about him a little cemetery in which, from time to time, he goes to pray, a cemetery of bitterness and regret of which he seeks. The reason for certain of his failures and the idea that we all carry a little graveyard with us of the errors and harm that we have done and it never leaves us in every. So often we go back to that cemetery and reflect upon the things we that were not as good as we would have wanted them to be. It's approaching the end of the year, typically a time to pause and reflect and make plans for the coming year. But how can we plan during such a time of uncertainty and disruption? Sometimes it's good enough to just get through the day, but if that's becoming harder and harder, it's time to talk better help. Is there for you
your help will assess your needs and match you with your own licensed professional therapist someone you can begin communicating with in under forty eight hours. It's not a crisis line. It's not self help. It's professional counseling done securely online log into your account anytime and message with your counselor or schedule, video or phone sessions. It's more convenient and more affordable than traditional counseling and better help is committed to finding you. The right counselor switch anytime easily and at no charge visit Betterhelp com doctor, that's better h, E L. And joined you over one million people who have taken charge of their mental health with the help of an experienced professional. So many, the better help is recruiting more counselors in all. Fifty states get ten percent off your first month at better help. Com doctor we get support from home hair, color company Madison Reed. Yet that's right home hair color made easy fun and read Dick uselessly, affordable and he'll get beautiful results a couple of our
producers and hosts you're wondering have tried Madison Reed, they ve said their hair felt healthier. After they colored it- that my because Madison re products are made with ingredients like organ oil and carotene, and with no ammonia caravans or sodium Laurel sulphate from color matching to step by step instructions guiding you through the process to caring for your color Madison Reed is there for you every step of the way. If you already Look, look like you went to the salon to get get those results on your schedule and at a fraction of the price, starting just twenty two dollars head right now, to Madison, read dot com use our promo code, pod and you'll get ten percent off plus free shipping. On your first color kit, that's promo code, Dr Pod, Madison dash red dot com, now, to find your perfect shade.
so in season two of doktor death we saw for red, fought, use his education and experience to intimidate patients, and he looked at me and he said: oh, are you in the medical profession? I said no, I'm an interior decorator, he said remember. I did do my fellowship at Sloan, Kettering, certainly you're, not questioning. Where did you get it? information from both of the doctors from doktor death had been through prestigious institutions and fellowships in their turn singing and that helped give them credentials. Can you explain for people who don't no the path to becoming a and the kind of training involved, so every doctor has to complete a four year college degree and then apply to medical school and that usually leads out the people who Can't do that amount of just garage
and of academic work is required and after four years of medical school somewhere three years these days, you do a residency in your specialty and that could be medicine, internal medicine, pediatrics surgery, and that can be three to five years you might do a fellowship two sub specialised, you might ever doing a medical residency to a fellowship and cardiology or mythology or after surgery you might do a fellowship in vascular surgery or plastic surgery. So you can be in training for ten twelve fifteen years and was doctors aren't getting out into the world
until their thirties. But then you, you have to get a job and we rely on letters, a recommendation as well as licensing and ports reflection exams. So you do do a boards ratification exam, that's general to everyone who graduates, medical school, the? U S, Emily used his medical licensing exam, but then in your field you have to go before it sort of occasion. So I'm internal, some sort of on board certified by the American Board of internal medicine. Tradition, has been a big. A huge test in you is taken every ten years. There's lot of criticism now board certification because part of it, you know self generating these tests are very expensive. So these boards earn a lot of money on that and it's not clear it's necessarily. You know during a great doctrine, but it doesnt show a certain amount of knowledge. You have to resort to fly, but then you dealers, a recommendation from your programme from your previous. You know. Employment is very hard to anything
less than a good letter recommendation. So where do you think the difficulty in reporting medical errors comes from one questions all? How do we learn? Medical error and most of us, as medical students, learn about it from M M conference morbidity and mortality conference, which is the monthly conference to review things that have gone wrong, and I have a crystal clear recollection of my first Eminem. I was Amerika and I was on the surgery, rotation and we were in a big room and the chief of surgery was conducting the mmm he's kind of a petite guy, but with a Texas sized personality and he scared the Jesus of anyone. I mean even the dean's quaked, when the structural walk by an
Remember that he told the resident who made the error to please stand up. I remember she stood up and he he looks at her now. Of course, I can't quite do his marbles in the mouth. Texas accent, something like you know. He says well even bother operating to see a guy out to the parking lot with a ruffle and shoot the guy? Why even bother operating- and I remember as a student watching this in shock the resident her face- the shade of grey she was, she was pass out and be our next admission. But I was a medical student and I was there to learn- and I learned three things that day one is a better, never make an error and two, if I do make an error, I'm not telling anyone otherwise I'll be up there getting screamed at
three I'm never going after. The hostile parking lot hundred was happening at their the reformers surgery, but I'm not go in there, and so we have this idea. That is either perfection or nothing, and there's no shaded great in between soap, how come, I think, would none of us. One talk about medical error and Making a mistake is inherently bad if you learn a lesson from it right yeah. I agree. I think that, as we make mistakes as we always will, it does make us better. I mean the hope is that it makes us better without harm patients, no one would ever have a new team of students or residents year for the money. I'll often talk about my mistake So, in addition to you know, what's your name or you from I rather like my top five big mistake, just so they know what you know when you make a mistake, If, when that, you can come to me in and well that's part of medicine. If you haven't punctured long you haven't put enough central lines. So if you have
Made errors in medicine, you just haven't been practicing long enough, and so when they happen, that's part of everyday practice. You know come to me and I suppose you know, take your the patient. Let's go talk to them about how to handle it. Unless it's a routine part of medicine in its life may medicine is life and errors will be made. The question is: can we catch him quickly? Can we trying to fix them, and can we learn from them? and try to protect our patients from future harm. I dont think most doctors go into it. For the money is, there Lots of doctors, I've lots of friends- were doctors near definitely easier ways to make a lot of money when wanted. Thinking about the pod cast. As I have to. Remind myself, and I have to remind people often who listen to it- that these Doctors are outliers the vat majority of doctors are good carrying people and who, who
care about their patients. The reason for telling these stories is because they expose larger truth, but They are not representative, you know, I don't tell these. Because our representative, I tell them because it is important to know these as caution. You know too, it's important to know these stories as cautionary tails I agree that in the part about the nerve wonders neurosurgeon debt reduction, keeping rehired because neurosurgeons or cash cows for institutions and and that always gets Michael's. You know why on earth. Surgeons reimbursed so much more than pediatricians or in so obstetricians, and it's because of our crazy system. You know most of what I handle most primary care doctors handle is chronic disease.
Diabetes is very common and in the main state of diabetes, now is education for the patient, how to eat how to exercise, how to take your medication, how to prevent complications, and if I spend a half an hour talking with my patient, about how to make brown rice instead of White Rice, which I do all the time you know what I turn is going to reimburse me. I don't know forty fifty bucks on a good day, but if, while I'm talking to my patient about You know how to cook kill my simultaneously threaten to into one of their orifices. You could pick any work as you want that reimbursement gossip I tenfold, and if I want to catch him, in over them at the same time than you're talking big bucks, soul, no wonder hospitals, you know lean towards things that bring in money, because our insurance system reimburses procedures over cognitive treatments. So all the discussions that that Christians do with no adolescence for harm prevention in their lives. That's not value, but if it
or an mri that is valued if you're in private practice. You know we're so, unlike you can bill for medication separately with chemotherapy. Then suddenly does matter in it in a very you know really tangible way and in so, but our our system again is is set up to reward procedures, and so people to then it's not a surprise. The one thing that common to me about both these stories. They were very different lot of ways, but they did have some common themes and one of the things I walked away relay thing profoundly is how hard it is for us, as patients, too, count a doctor? I mean it's really really difficult to get information. You referred to this person, of course. What do we do? We go on the internet because that's what we used to doing when we do anything has tried to check out to see what we can find on the internet and
get into these health rating websites, and my view, is those can be incredibly mess. Eating? I mean if you look at the case, some Christopher dont, you had four point five out of five stars and I saw a light com its and reviews, and one of the reviews. I recognise the name as being one of his former girlfriends posing as a patient. I mean tools, for us are really limited. Could you talk about them? I in the online reviews. Oh just drive me crazy because there truly meaningless because of what people are typically reviewing. Is the patient experience. So there's one doctor's office with the great coffee machine and really nice staff, and you get seen quickly that feels great you'll put a high review, but that is not reflective at all of how good this doctor is. I knew one colleague who checked herself online and discovered that she was not rated that highly
pushing Doug into it and she was very low and efficiency efficiency when she dug deep deep into it. It she discovered, because she was taking too long, spinning how much time with patients use when is inefficient, but of course that the doctor, you would want someone who spends less time with you, but amount is low low rating, so there are very hard to judge in others. It you heard credits very difficult to find information you want, and then you can check on your doctors license. You can check on their board certification for what that's worth you can see if their appending losses on them there's something called doc. Info dot org, and that gives you mid school, your port certification license and any actions, but that's pretty limited I mean what you really want to is someone good and are they wise and we often, I think, confused being smart and being wise, and you know I think most of
they're, pretty smart. I marking they got through met, scorn all but but being wise and end you knowing not just what to do, but whether they do it and how to do it and it would read all those are to me the hallmarks of system and a very hard thing to pick up on an online rating, which is what usually right, you're microwave or your local chinese restaurant? And so there is no. The answer to that unless someone's been egregious, although as you son these two by gas- that even the greatest is hard to find that out, why is it so hard? Is it truly hard? Is it legal hard, because it is hard I understand, for one doctor to to call out another one, even if you know or strongly system it's all of the above so culturally
it is difficult to we. You know tender, respect each other birds and hard to get into medical school. We are and we don't wanna harm. You know someone colleague, but it also in terms of processes very difficult, and you can argue that it should be because it otherwise would be easy to certain have very frivolous things. You don't like someone, you could call them out and something, but there's all owe you a long process and you can't fire some without cars, and the problem is, you know, cause is hard to identify so, S. Ok, someone is doing the reckless medicine like the doctors, your profile you could and even then it was hard, but you could make him put purchase someone's got poured judgment, you know or they're, not so thorough things that are very small.
Cause but, like we all know amongst you, so that you know I'm not an example of that doctor there a little bit, you know lazy or they're, not that thorough and attentive to detail how he called out. It is very hard to do so. We don't have a good system that a lot of people have really am come down in my view. Justify on some of the people who did know and didn't speak up, it went When it became clear in the case dont that in there and there was no question, but there were no shape. Of gray with that doctor, whenever gave when they were still like night, not term intervening, and that's how shocking, because that's what you think about over the ethical ramifications, I mean hospitals, don't take an oath, but doctors take an oath, and so you do have an ethical obligation. If you see clear and present danger to patients, I can't imagine
which you wouldn't do that, certainly lease anonymously or through a back channel. I think it's an unreal ship, and certainly there was the phone call we heard in season, one savagery Henderson, I'm good. I'm hoping you can help me with a problem. Are you familiar with neuro surgeon by the name of Dr Dunce, Christopher dunce yeah? Well, so am I unfortunately, I became aware of him on. Were the two Harrison call. The ceo of a hospital who really did not want to hear talk about this and then hung up and didn't didn't call back, and they really would rather go away because hospital care about their image. If you
start stealing your image, you're gonna lose all those expensive elective surgeries, all those new replacements in and just surgeries too. Computer up the road, so hospitals have the strong incentive not to want to do that. So how then, can we prevent the doctors who are most dangerous because they don't feel this remorse her? For whatever reason, how can we prevent them from hurting people? So who knows who knows is the staff with the other doctors and nurses? There are the ones who know, and there has to be a way to allow them to speak confidentially and honestly about that, and then there has to be a mechanism for the hospital or an incentive for the hospital.
I mean you talked about how, in the first episode that the first hospital reported by doktor, don't just let him go with sort of a very benign sounding. You know no reason for leaving as opposed to a party whose reporting him is a huge ordeal me could get soon also get a disincentive for the hospitals. So I think again, you need a mechanism for hospitals, the institutions to build a fire. Someone report someone without having backlash. I was really struck it in with that refer to the nurse who apply for a job and saw all these obvious violations of protocol and filed report. That's how we
We here are our medical assistance. Hang chemo, I dont have a really good poker face and I know that my mouth can drop to open my eyes. You know got really back to me. That seems easy, because here are clear protocols for how to give chemotherapy, and I was shocked that that was not followed up on my because judgment call at that's hard to do. You know the checklist, but how to give chemotherapy there's a checklist out there. That should have been easy to do. You know to file citations, and I dont know why that that didn't happen the one thing that nurses to have. It is protocol that and sometimes to a false nurses, are the ones who really keep track of protocol in a hospital or in a medical office, and so it can be easy to point out when things deviate from protocol and that should be away because that seems obvious and to meet in the fault lies with the medical board. How come those deviations of work
did not raise red flags. Why wasn't there an inspector I wanna go back to some of them. Some of the hierarchy which we talked about earlier, the nurses, doctors, other people who might say I want people to understand how difficult it can for some of these other people. George garage was an office manager in it was hard for him. You had. We know we ve talked about The nurses who, who in this hierarchy? Do you think is it the best position or should be in the best position to really protect. When they see something wrong? Well, who is should or two very different things. The hierarchy is so powerful and medicine I'll. Just give you an example. When I was a medical student, I was in a late night surgery. I forgive for
what it was, and this is during the higher the AIDS epidemic and my finger was pierced by the surgeons needle and nobody said a thing. The nurse didn't say anything the doctor didn't and I stood there waiting for someone to say something and nobody did
I didn't and the fact that in the middle of the HIV epidemic that I have had my finger pierced in a pool of blood and didn't say a thing for two hours lets: you know how powerful the hierarchy is. I just couldn't break out a hey. Wait, a second guy something happened. That's our strong! It is so every nurse every office manager, I'm every medical assistant, is in the hierarchy and the pressure to not say a thing is so powerful because you risk upsetting the whole apple cart and if it isn't going to translate into a change than you, ve just ruin the rest of Europe, no professional life with that personnel working with. So you have to really say this is worth it and is very, very hard to do.
Diana Megan Brenda wait, who that's what Diana called the queen. This season were bringing you an encore series about the royal family guy in time, for the return of the crown were Tell you what really happened between Diana and Charles and how their What influenced Harry and Meghan's decision to leave the royal family and be sure stick around for a juicy bonus episode since have to even the rich on Apple podcasts, Spotify, the Wondery APP or wherever you're listening right now join, play in the wonder yap to listen ad free. You know we were king a lot about and harm can you make me feel a little better here? alleviate the fears cause. I don't want people to be.
Afraid. I mean it's important to tell these stories. I think because they do expose vulnerabilities and I think we could use them as teachable moments, hopefully but but make me feel better about the medical system. So here's a teachable moment so in March and April, when Covid came to New York City as it is all over the country, the medical profession and all the health care workers in the nursing profession rose to the occasion like we've never seen before, and I think people were quite astounded at the personal risks that healthcare workers are willing to take on behalf of their patients, but those of us on the inside. We were not surprised. I think we knew this that really everyone in the system is there, because they want to help patients and we'll do whatever it takes to do it, and we witness that in space during the cove pandemic, and if people who are in it just for the money they would just take.
Often leave town and go hide in a bunker, but no they went in and took care of these patients. A great personal risk to themselves: do you think Covid has helped the public really see, though, how my doctors and nurses care about their patients, not that we didn't see it before, but it just demonstrated it instead starck way is I think that the stark relief of covered, let people know what I mean Doctors and nurses do every day and on a small scale, but that they're always doing it and it was the same during the AIDS epidemic and and the same during each one and one during the hurricanes that we ve had.
By and large doctors and nurses, wool work or the ends of the earth for their patience, and I see it all the time every day and costly impressed at how much by colleagues care. I will really do what it takes, and I ethic boy so he ever happened to me. I would gladly have my colleagues to care of me or my family. I will trust them with my wife and I, also fortunate to being a profession that people care about something and we listen, we could be working in an import raw were, or some corporate being unjust, worrying about scalability in which its in spreadsheets in no aren't we force to be in a place where you can actually make someone feel better, even if, just by a little bit. How great is that you can improve someone's life? Even if you can't cure them, you can ease their pain, help their death be easier, half of come to terms with the difficult I ignore says we're so lucky
in this field. Will that restores my face? The issue that might be taken away by what we have is that the take away from the horrible doktor stories for you, the time to take away, is, is through its range of human psychology that they're always outliers in terms of personality and psychological disorders, sometimes there in Wall Street, and we see the effects of that. Sometimes there in medicine, waiting effects of that are sometimes in government, and we see the effects of that. This is the human species and that there are outliers and wood we're profession? They pick up. They will cause harm and damage. So people who may be listening and worrying tell me, maybe conquered things that people can do to figure
whether they could trust their doctor. Well, I would say that I would have a high index of suspicion for anything that someone offers you as advice So if a doctor says, I think you should get an mri, you should, instead of just saying sure just say: oh, why do you think and what are other alternatives? Can I get? second opinion and I think we should do that for all of our medical care, irrespective of these two, in outline is if a doctor recommends you know it's time for surgery is very important to get a second opinion or surely ask no one of the risks of the surgery versus the benefits. How do they wakens each other and what's the risk of not doing surgery you how these compare, because as they say, no, if your surgeon, then everything looks like you know, even operation, because there are procedural- is now, of course, the best surgeons, other ones
say you know you don't need surgery. Now, that's the mark of a good surgeon who says you dont need that right now and went about any. You know the code that you could get like if you referred here too, doctor, and maybe because we talked about the difficulty, but can you say like what would you send your spouse? To this point, Would you send your like like nurses, as we talk, TAT have a difficult time at one and the patience of doktor. Take that. You know you talk to the nurses and ass. A nurse like well would you send your loved ones to this person and the nurse will say yes or no and that's a big red flag? Yes, I actually is as talking to that the nursing staff and the other doctors is. Where would you send your family member, you who do you trust or who have you gone too?
who is, it is again some sensible won't say, but they will say who they would recommend, and maybe they made I'd say don't go here, but if they have but try this person, who I really trust one question to ask your doctors. How can I get in touch with you if I have a question. Now. I'm sure a doctor, father or Doktor Dodge is not going to make that easy, but if you're, so you know you ve been the patient portal or here's my nurses number or here's the office hours that you can call. That's always a better sign and you should be able to ask a question and if someone is not taking a question means or shutting you down? That, I think, is a red flag and I was it struck me that that you know the patient, who did try to question got what about you didn't transform Catherine kind of response that should not fly all. That's that's not an appropriate response and to me that's a red flag. Anyone who has
Easy pat answer like that, I would say, is inversely proportional to their ability and quality by the smarter doctor say. No, I don't know the answer that question Europe through. I don't know, go look that up. That's a sign of a smarter doktor, so you can try You a situation with the patient were I'd, biased him to get a procedure that went dreadfully wrong. So wrong that I said to me: no, I wouldn't then. If you wanted to fire me- and he said you know actually that made him to keep me more because I spoke to you about what went wrong and how bad I felt about him. So, just by sort of opening up on that and admitting boy that really didn't go well made him. Me more, and so, if your doktor isn't willingness
admit when they don't know or when they made a mistake, then that's a red flag and medicine is very complicated and there are a lot of moving parts, especially for a very sick patients. So even if you're betting, you know close to one thousand, a couple things will go wrong, and so what happens? When that happens, you know, does your doctor say? Oh you know we should have done this. Look at that. It's actually a positive sign and not a negative sign. And I think we tend to want people of all the right answers, but look for doctors who are willing to say I don't know, I'm not sure they have asked the doktor. I want I think that's a great way to to leave this discussion on that and I want to thank you so much for talking with me. It's my pleasure. Thank you. So much for having me that's doktor, Daniel free, doktor, o free, is a physician at Bellevue Hospital in New York City and the author when we do harm a doctor, confronts medical error.
from wondering this is episode. Five of five of season, two of doktor death to listen to both seasons of doktor death ad free. You can join wondering plus in the wondering app I'm your Most Laura Veal Heather swearing, wrote and reported. This story assist a producer is Chris single story. Editors, Casey minor fact, checking Jaclyn collecting additional production assistance from Daniel Gonzalez manage producer is Latta Panda, sound design by Jeff Schmidt. Our executive producers are George Lavender Marshall, Louis and Hernan Lopez for wondering going to. Tech are in an all out race to cash in on our collective addiction to social media. It's a fight
I started in Silicon Valley. That's now gone global hi. I'm the brown the host of wandering show business wars. We go deep into some of the biggest Corporate rivalries of all time, and in our latest series we tracked between Chinese in american Start ups, as they do get out for our eyeballs, but tastes are fickle. Minus four for Tok versus Instagram, listen Apple, podcast Spotify were listened. Free by joining one reply, ass in the wondering app.
Transcript generated on 2021-01-25.