Within forty-five minutes, they did a bone marrow biopsy, and in two hours had the results, and started antibiotics.
Seasoned staff and specialized facilities can help avoid mishaps. Jim explained:
You have to be in a place where the nursing staff, in particular, takes care of these problems all the time. My local hospital didn’ t have a specialized oncology floor or leukemia service.
Over time, attitudes toward medical errors have changed. As suggested earlier, an unwritten code exists against criticizing fellow doctors that extends particularly to suing. Physicians, aware how malpractice suits have become out of hand, hesitated to engage in this same process themselves. Jacob said,‘‘ Suing doctors for malpractice is a crime— worse than a crime, a religious crime! Because it assumes that doctors are as good as God.’’
Before the era of wider malpractice suits, mistakes may have been more accepted: readily discussed and recognized as inherent in medical practice. Indeed, Harry, the war refugee with heart disease, described a yearly ritual at his hospital, designed to permit talk and laughter about mistakes.
The hospital furnished the beer. It was a nice, amusing occasion, and you got to know your people. One doctor did a sigmodoscopy, found an obstruction, and biopsied it. It came back‘‘ normal cervix’’! He thought he was in the colon, but he had gone into the vagina! Another doctor thought a woman was pregnant. He followed her, wondering why she didn’ t get more pregnant. Finally, he did an abdominal tap and got a lot of fluid. The woman wasn’ t pregnant. She had ascites. One doc described a patient as smelling‘‘ uriniferous.’’ He’ d forgotten that he’ d examined the patient at night in the men’ s room. Then malpractice came, and that was the end of that.
He thought such an event had many beneficial functions.
‘‘ Screw-ups’’ 91
Doctors would tell their own stories. Dignified physicians put an Indian blanket over their heads and went in a circle, chanting and waving tomahawks. You didn’ t even know who was under this blanket.... Interns were pleased: everybody loosened up. The department was very cold. It was an opportunity to get a little closer to the attendings: relaxed, friendly, quasi-intimate.