Beware the Grieving Warrior

Beware the Grieving Warrior: A Child's Preventable Death. A Struggle for Truth, Healing, and Change
Larry Hicock with John Lewis

"This book is a riveting read not only because of its heart-wrenching outcome and local characters, but because of its potent topicality: According to data collected from Britain, Australia and the U.S., an estimated 10,000 Canadians die in hospitals annually as a result of medical error, another 10,000 from incidents like hospital infections and unexpected drug complications. It's something we always hear, but due to a naive trust in our medical system, rarely put into action: You are your best advocate."
- Hamilton Magazine

In early 2003, Ontario's deputy chief coroner ordered an inquest into the tragic deaths of two children due to post-operative complications in a Hamilton hospital. The cases may never have been reported were it not for John Lewis, a registered nurse, and father of 11-year-old Claire -- one of the two children.

Beware the Grieving Warrior describes John's fight, in the midst of immeasurable grief and sorrow, against hospital staff and administration who failed to acknowledge their neglect. By turns shocking and heartrending, infuriating and inspiring, this book offers a chilling first-hand account of the obstacles and resistance Lewis encountered as he wound through a hellish maze of bureaucracy, until he won his day in court. The story is intensely intimate and brutally honest. It is about the suffering that inevitably results -- for patients, their families, and for the health care professionals involved -- when the truth is withheld.

At Amazon
http://www.amazon.com/Beware-Grieving-Warrior-Preventable-Struggle/dp/1550226738
At ECW Press
http://www.amazon.com/Beware-Grieving-Warrior-Preventable-Struggle/dp/1550226738
As eBook
http://www.diesel-ebooks.com/cgi-bin/item/1554906733/Beware-the-Grieving-Warrior-A-Child's-Preventable-Death-A-Father's-Fight-for-Justice-eBook.html

CMAJ - Apology marks new era in response to medical error, hospital says
http://www.cmaj.ca/cgi/content/full/168/6/757

Grieving father John Lewis says there are no "real winners" in this case
http://www.cmaj.ca/cgi/eletters/168/6/757#273

Patient Beware
http://www.readersdigest.ca/mag/2004/06/patient.html

CMAJ: Medical errors, apologies and apology laws
http://www.cmaj.ca/cgi/content/full/180/1/11

Articles by J.E. Lewis at NIH
http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&term=Lewis%20JE%5Bau%5D&dispmax=50

Doctors find confession is good for the soul
http://www.rd.com/living-healthy/doctors-confess-their-fatal-mistakes/article185422.html

The foundation established in memory of Claire Lewis is called Revolution Hope.

Six Sigma and Medical Care

Does your hospital utilize Six Sigma in its planning and methodology?
Six Sigma Catapults Hospitals to Next Level of Quality
If not, the consequences can be very costly to you...and to the hospital.

"Lawsuit could set precedent about end-of-life decisions

Robert Cribb
Toronto Star
Staff Reporter
September 04, 2010

As her father lay struggling for breath in a Toronto hospital bed, Joy Wawrzyniak pleaded with doctors to intervene and save his life.

Medical staff instead stood back and allowed the World War II veteran to die, against his wishes and to the shock of his daughter, Wawrzyniak claims in a stunning $1 million lawsuit filed this week against Sunnybrook Health Sciences Centre and two doctors responsible for her father’s care.

While Wawrzyniak and her father, Douglas (Dude) DeGuerre, had repeatedly requested he receive life-saving treatment in case of a medical emergency, doctors unilaterally overruled those wishes without consent or consultation, the lawsuit claims...."
Lawsuit could set precedent about end-of-life decisions

Thyroid T3 Recovery from Fibromyalgia

What if... your doctor prescribed years of pain killers and antidepressants for your Fibromyalgia... when what you needed was thyroid supplementation?


"Recovery from "Fibromyalgia" with T3
Therapy after T4 and Desiccated Thyroid Failed

Fifteen years ago, I published a case study in which a hypothyroid female dramatically recovered from her diagnosis of fibromyalgia by swithching to T3 after she had failed to benefit from both T4 and desiccated thyroid.
Fibromyalgia researchers who work with their heads buried in the sand of failure will dismiss the case, as they did all those years ago, because the report isn't about a blinded study. However, as Carlton Fredericks, PhD noted, such reports are controlled. After all, the woman recovered quickly and dramatically with T3 after extensive treatment with two other approaches to thyroid hormone therapy failed. It is a failure of intellect that dismissive fibromyalgia researchers saw (and undoubtedly will still see) the study as "uncontrolled." By the very unfolding of the woman's case, the trial was indeed controlled.

This highly illustrative case of recovery from "fibromyalgia" through thoughtful administered T3 therapy has for many years been unavailable except through my office. The reason is that the journal containing the report was sold in 1996 to Haworth Medical Press, which didn't make the issue containing the report available to subscribers.

Today, however, Thyroid Science makes the case report available for perpetuity through its open-access webpages. For those who are curious about T3 therapy and its proper use, and how so-called "fibromyalgia" can be relieved with hormone treatment, we republish this case report. "

Introduction to the Case Report at THYROID SCIENCE

Do you trust your doctor?

Do you trust your doctor? Increasingly, many (Canadians) do not.
It may be wise to ask questions. Today, university medical education is often funded by Pharma (grants to chairs and departments, for research, dictating what shall be taught) and continued in the doctor's office during visits by drug company reps with high school educations and doctor prescribing info and personality profiles on their Bl*ckberries.

From an article at Maclean's

...horror stories have made Canadians wary, says Mario Canseco of Angus Reid Public Opinion, who oversaw the Maclean’s poll. “Not only do they worry that there will be mistakes, but they assume so,” he says. “Even if you’re happy with your GP, you see what’s happened to those around you. You think it may be your time next.”

For doctors, this is an unaccustomed, and not especially pleasant, spot to be in. For generations, physicians have enjoyed greater public respect and appreciation than practically any professionals—a reflection, perhaps, of their status in many communities as the most educated people in town. That’s changing, however, as post-secondary education becomes the norm and Canadians in general grow less deferential. “There used to be a very paternalistic relationship between doctors and their patients,” says Dr. Rocco Gerace, registrar of the College of Physicians and Surgeons of Ontario. “It worked both ways. Patients would essentially give doctors the decision-making ability, as opposed to considering options and then consenting. It’s changed dramatically, and I think for the better.”

That shift has been accelerated by the Internet, which puts not only diagnostic information but reviews of individual physicians at the fingertips of patients. RateMDs.com, a California-based site that went online in 2004, has doubled its traffic every year since, with Canadians as its most enthusiastic constituency. The site now has user-submitted ratings for over 85 per cent of Canadian doctors, and a surprising 45 per cent of its 1.2 million monthly visits originate in this country. The phenomenon speaks not only to patients’ doubts, but an appetite for frank criticism that Hugh MacLeod, chief executive of the Edmonton-based Canadian Patient Safety Institute, says will only grow. “For those in the system who think things are getting wild now,” he says, “put on your seat belts.”

All this crowd-sourcing raises an obvious question: are medical mistakes becoming more common? Or are they merely being amplified by proliferating media, both social and mainstream? Geoff Norman, a McMaster University psychologist who studies how doctors make errors, believes recent scandals played out in the media have simply caused patients to demand reviews and investigations, the coverage of which has fed impressions that things are going awry. Doctors are more willing to own up to mistakes, he argues, and he points to the publication in 2000 of “To Err Is Human,” a report by the Washington-based Institute of Medicine, as a watershed moment in encouraging practitioners to acknowledge their fallibility. “Now,” he says, “there’s almost like a legislative review process when something goes wrong.”

http://www2.macleans.ca/2010/08/16/do-you-trust-your-doctor/
Print version
http://www2.macleans.ca/2010/08/16/do-you-trust-your-doctor/print/

Patient Empowerment in Medicine

Many medical professionals are often years behind in their reading; understandably they don't like empowered patients.

Some doctors don't like patients who challenge them. Such patients take time and make a doctor work hard. Most doctors want to be considered the authority - even if it kills you.

If you see annotations in your medical file - "patient is getting information from the internet" - it is probably time to move on for the sake of your health and wellness.

Link

What Exactly Are They Teaching in Medical School?

What Exactly Are They Teaching in Medical School?

Dateline: 05/05/97
In the May/June issue of Health magazine, there's a familiar but frightening story. The article by Barbara Bailey Kelley describes a woman who had constant fatigue, constipation, constantly feeling cold and difficulty swallowing. According to the article, this group of symptoms had the woman "hopping from doctor to doctor. None could identify a medical problem." Three years after her symptoms appeared, the woman was checked into a hospital, where a coterie of specialists -- an allergist, heart specialist and psychiatrist -- examined her. The psychiatrist wondered if she was suffering from depression. After a battery of tests which, WHEW, finally included a thyroid-stimulating hormone (TSH) test, they FINALLY discovered that she was very hypothyroid, in fact, her thyroid had almost shut down completely.

Okay, calling Dr. Kildare! Marcus Welby! The entire staff of St. Elsewhere, Chicago Hope and ER! Where are the doctors who recognize thyroid disease's symptoms quickly?

On an AOL chat a few weeks ago, a group of us were speculating what would happen if a woman with a basketball-sized goiter walked into the ER at "ER." We decided she'd be told she was stressed out, and sent home with a prescription for Prozac, AND a big fat bill from the emergency room (that her insurance company would probably deny!!!) Now how bout that storyline for dramatic tension? (Of course we all agreed we'd keep the goiter if it meant George Clooney'd be our endocrinologist!)

In any case, doesn't it seem like anyone who's spent more than five minutes reading anything about thyroid disease would have a problem recognizing the familiar litany of symptoms the poor woman in the article described? In fact, I sometimes have to watch about becoming too evangelical myself when friends say, "you know, I've been feeling a bit tired and run-down lately, and..."

"COULD BE YOUR THYROID!!!" I announce.

Continues at Link

A Doctor's Rx for CEO Decision Makers

A Doctor's Rx for CEO Decision Makers
by Jerome Groopman, MD

From the essay:

Doctors, like business leaders, make mistakes. Some errors are purely operational. A pint of blood is mistakenly transfused into Joan Smith rather than Jane Smith, and Joan goes into shock. A young doctor writes an incorrect dose of chemotherapy on an order sheet, and a woman with breast cancer dies from the toxic effects of overtreatment. A neurosurgeon operates on the wrong side of the brain because an X-ray was mislabeled as "right" rather than "left." These kinds of errors make headlines, trigger lawsuits, and terrify patients and their families; in the academic world, such mistakes prompted the Institute of Medicine to publish the landmark article "To Err Is Human" in 1999. Leaders in health care took the IOM recommendations to the business world for solutions. Lessons learned in high-risk industries such as air travel and nuclear energy were applied to hospitals. Anyone who has recently had a medical procedure or treatment has benefited from the checks and double checks that have become routine. To ensure that the right patient receives the intended care, health care professionals, like airline pilots, now follow strict protocols.

However, operational mistakes account for only a small percentage of medical errors. The overwhelming majority reflect poor thinking. In fact, 15% to 20% of all medical conditions are misdiagnosed. A middle-aged man's indigestion, treated with antacids, turns out to be a heart attack; a child's chronic headache is due not to "family stress" but to a brain tumor; a grandmother's fading memory is not early Alzheimer's disease but vitamin B12 deficiency. Such diagnostic errors reflect shortcomings in physicians' thinking rather than technical mistakes. In 2007, a national conversation began in the medical field about how best to address these errors of judgment. Business practices were not the solution this time; in fact, CEOs and other senior managers would do well to adopt the strategies that physicians are pursuing.

Senior doctors, like CEOs, traditionally have cast themselves as confident, autonomous decision makers; they take pride in their rapid analyses and sure-footed recommendations. Their judgments filter through the hierarchy in much the same way that decisions in a company are disseminated from the corner office. However, in sharp contrast with most businesses, hospitals convene regular meetings where all faculty and trainees—from the chief to the beginning medical student—revisit cases that had poor outcomes. At these forums, participants are beginning to dissect doctors' misguided thought processes, not just discuss bodily organs. This shift has required that even the most esteemed physicians acknowledge their fallibility in an effort to teach others and to improve themselves.

Medicine is drawing on the work of cognitive scientists—particularly Amos Tversky and Daniel Kahneman, who three decades ago explored the benefits and risks of heuristics, or shortcuts in thinking. Heuristics help to explain the 15% to 20% of cases where we get it wrong. My extensive research on misdiagnoses shows that even the most seasoned physicians are highly susceptible to anchoring error, or seizing on the first bit of clinical information that makes an impression. Similarly, all doctors recall dramatic past cases of theirs and mistakenly apply them to the case at hand, a so-called availability error. Another cognitive trap is attribution error, whereby a physician relies on a stereotype to which he attributes all of his patient's complaints. Menopause, old age, and stress are common categories that physicians glibly invoke as explanations for vague symptoms without digging more deeply for other causes. Contrary to the image of the doctor as authoritarian, dismissive of criticism, and resistant to self-analysis, physician leaders are starting to welcome the insights of cognitive science to help them avoid errors of judgment, in part because they have recently seen the benefits of rectifying operational errors. By making themselves vulnerable, physician leaders have now begun to encourage those lower down in the hierarchy to question decisions more freely and think more broadly.

"...hospitals convene regular meetings where all faculty and trainees—from the chief to the beginning medical student—revisit cases that had poor outcomes..."
We wish...

Link