Back when I was training to become an emergency physician, I'd worry about the day I'd be involved in a medical error. It seemed inevitable. With land mines everywhere — the possibilities of missed diagnoses, delayed treatments, miscommunication — it felt as if almost anything could lead to catastrophe. I imagined attending the in-house case review afterward, chastened as my hospital colleagues dissected my decisions. Yet I also thought that something positive would come from the process, that lessons from an error would sharpen my clinical skills and improve care in the hospital.
But when I was entangled in my first medical error, I played an unexpected but common role: I was a 33-year-old son trying to save my mother's life.
The call came to me in Boston out of the blue one morning in September 2010. On the line was an emergency physician in the Wisconsin town where I had grown up, telling me my mother was sick. He sounded harried, and I heard papers rustling in the background.
My mother was already fighting breast cancer, but he was calling about a new development. During the preceding year, my mother had been getting chemotherapy for a recurrence of breast cancer, for which she'd treated in 2008. The chemotherapy had been working: My mother's cancer was stable.
But she'd suddenly worsened on the morning of the phone call. My dad found her barely responsive in a chair at home, and he called 911. When she arrived at the emergency department of the local hospital, she had a high fever, her heart was racing and her white blood cell count — critical for fighting infection — was extremely low. I knew what was wrong: neutropenic sepsis.
I often diagnose and treat cancer patients with this condition. It meant that my mother had a serious systemic infection complicated by her body's severe shortage of infection-fighting cells, which had been nearly eliminated during chemotherapy. The condition is well known, easily diagnosed and has a clear and standard treatment protocol.