As a health care provider it is refreshing to see someone like Marsh openly talk about his bad cases…and his desire to stop the un-needed admin and bogus “training” that had little to do with one’s practice. Additionally, if you start with all folks desire equal healthcare….and should receive such then moneys are better spent stopping all the DEI…if you improve education at the lower levels than trying to change things at a medical residency level can be catastrophic. Wokeness must never invade medicine…but following covid so many providers remained quiet to the mismanaged and lethal politics allowed to corrupt medicine to its core.
I read the last quote and translated it as "Every human carries within himself a small cemetery..."
I kneel at the graves in my cemetery perhaps too often.
While physicians should heed the call to humility, so should patients and caregivers. Each one of us, by the time we are decades into life, would, if we could, repair errors that have grievously harmed others.
He’s my age and I can relate. My overall best experiences were with the families - I’ve written about that in a Substack. Wait. Did I publish that?
Although I made it through 35 years of Critical Care this piece reminds me, once again, that my most vivid memories are of my failures, some small and of little consequence, some catastrophic. Fortunately there aren’t many in 35 years of active practice but they, to this very moment, are indeed my most vivid recollections.
After each one I reported myself to Quality, possibly as an act of confession but more just to let my colleagues knew that I was AWARE. Too often I was told whatever happened was “within the standard of care” and, while that kept my record “clean”, I knew better and it was of little comfort.
And, after each one I tried to understand what went wrong and the decision which led me down the wrong road. One thing stood out: I was always 100% sure what I was doing was the correct course. After a few years I learned that when I’m “100% sure” that’s a red light, not a green light. Eventually, like Dr. Marsh, I stopped at that point and reconsidered, ran it by the patient’s nurse, or asked a colleague. There’s a time and place in Medicine for ego.
Making that mistake is the loneliest place in the world. You are alone with God in those moments. No one on Earth can make you feel better about it. There is no quota of rationalization or blame-shifting that suffices. In the end you know it was you writing that order, or placing that chest tube. And you know you’ll feel that until you don’t feel that way anymore.
And, ultimately, you have to get up the next day and see 12 patients again. And do it better.
As a health care provider it is refreshing to see someone like Marsh openly talk about his bad cases…and his desire to stop the un-needed admin and bogus “training” that had little to do with one’s practice. Additionally, if you start with all folks desire equal healthcare….and should receive such then moneys are better spent stopping all the DEI…if you improve education at the lower levels than trying to change things at a medical residency level can be catastrophic. Wokeness must never invade medicine…but following covid so many providers remained quiet to the mismanaged and lethal politics allowed to corrupt medicine to its core.
I read the last quote and translated it as "Every human carries within himself a small cemetery..."
I kneel at the graves in my cemetery perhaps too often.
While physicians should heed the call to humility, so should patients and caregivers. Each one of us, by the time we are decades into life, would, if we could, repair errors that have grievously harmed others.
He’s my age and I can relate. My overall best experiences were with the families - I’ve written about that in a Substack. Wait. Did I publish that?
Although I made it through 35 years of Critical Care this piece reminds me, once again, that my most vivid memories are of my failures, some small and of little consequence, some catastrophic. Fortunately there aren’t many in 35 years of active practice but they, to this very moment, are indeed my most vivid recollections.
After each one I reported myself to Quality, possibly as an act of confession but more just to let my colleagues knew that I was AWARE. Too often I was told whatever happened was “within the standard of care” and, while that kept my record “clean”, I knew better and it was of little comfort.
And, after each one I tried to understand what went wrong and the decision which led me down the wrong road. One thing stood out: I was always 100% sure what I was doing was the correct course. After a few years I learned that when I’m “100% sure” that’s a red light, not a green light. Eventually, like Dr. Marsh, I stopped at that point and reconsidered, ran it by the patient’s nurse, or asked a colleague. There’s a time and place in Medicine for ego.
Making that mistake is the loneliest place in the world. You are alone with God in those moments. No one on Earth can make you feel better about it. There is no quota of rationalization or blame-shifting that suffices. In the end you know it was you writing that order, or placing that chest tube. And you know you’ll feel that until you don’t feel that way anymore.
And, ultimately, you have to get up the next day and see 12 patients again. And do it better.
Thank you, Dr. Ward, for this compelling review. Sounds like this will be my next medical read!
I read both of his excellent memoirs!. Happy Birthday Dr. Marsh.!