Tell us your greatest mistake and what you learnt from it
We all make mistakes, although some people believe they never make them and others are too ashamed to confess. We can all learn from our own mistakes and those of others, and we invite you to share yours with the world via this website. They should be focused on medicine though needn't be clinical and may relate to your career. See below for two examples.
We will publish the most engaging and useful in this year's Christmas issue.
Submit your mistake
Read others’ mistakes
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First into the confessional were Dave Sackett and Richard Smith:
Skoda’s Fool
As the solo intern in charge of a Chicago emergency room one August night in 1960, I was grappling with three dozen former passengers (by then, aspiring personal injury claimants) of a city bus involved in a minor accident. Most had demanded x-rays in hope of fracture, and groaned to potential witnesses as they limped about the ER.
Into this cacophony descended a thirty-ish scrub woman who said she’d developed a non-productive cough and increasing shortness of breath over the previous two weeks. She wouldn’t wait for blood work or a chest film, so I conducted a quick exam in a noisy cubicle. All I found were hyperresonance to percussion over her upper lung fields and an evanescent wheeze. I prescribed the contemporaneous asthma regimen, arranged a follow-up appointment in the medical clinic, and promptly forgot about her. . . .
. . . until she was presented at Grand Medical Rounds 6 weeks later as an interesting patient whose lymphoma had presented as bilateral pleural effusions. When she described being told by an ER doctor that she had asthma, the audience snickered in derision, I froze in mortification, and the Physician-In-Chief did three remarkable things. First, he didn’t call me out of the audience to chastise me before my peers and betters. Second, he took me aside after the round, both to discuss my error and to teach me about "Skodatic resonance" above pleural effusions. Third, he didn’t hold my dumb mistake against me, and became my mentor during my first residency in internal medicine.
DL Sackett, Trout Research & Education Centre at Irish Lake, Canada
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A fool such as I
Making mistakes is an essential part of being human. Ralph Waldo Emerson said: "All life is an experiment The more experiments you make, the better." He might have written: "All life is mistakes. The more mistakes you make, the better." Mistakes are great teachers, but they also allow us to get through the day. Try to spend a day without making a mistake, and you’ll do nothing. So I find it hard as I survey 52 years of mistakes to pick my biggest. I’m spoilt for choice.
But since this is a medical journal I think back more than a quarter of a century to a man in his 50s who was admitted to the ward on which I worked. He was a true cretin with congenital hypothyroidism. He had pneumonia and was in respiratory failure. Should we treat him? All we knew about him was that he lived with his elderly mother. After much debate—a debate in retrospect that was wholly uniformed by ethical analysis—we decided that we wouldn’t. He was tucked up in bed, and I went home.
When I arrived the next morning he was sat up in bed, reading a comic, and surrounded by visitors. He was, I discovered, the most popular person in his village. His mother was devoted to him, and I soon came to like him. After a few days he went home.
This was a mistake with wholly positive outcomes. The patient did well—and might not have done if we’d tried some heroic treatment. I learnt about the severe limitations of medicine and that I was a fool. Only unthinking fools could have decided to leave a man to die without learning more about him and talking directly to his relatives. I couldn’t claim now not to be a fool, but that mistake made me a wiser fool.
Richard Smith
Former editor, BMJ