Readers Write: Lessons From an Emergency Room Nightmare

By Heather Gehlert, AlterNet. Posted December 27, 2008.

About 16 percent of Americans don't have health insurance. For them, dealing with an illness often means either getting socked with a costly out-of-pocket appointment or simply going without care. That's a story the media tell us almost daily. What we don't often hear about is the quality of care for the 84 percent of Americans who do have health insurance. For them, seeing a doctor can be both a blessing and a gamble.

Doctors misdiagnose their patients up to 15 percent of the time, according to an article in the May issue of the American Journal of Medicine. And missed or wrong diagnoses account for a full 17 percent of "adverse events" in hospitals, a landmark Harvard study shows. Diagnostic errors can happen just as easily for benign conditions as for potentially fatal ones. Since every person's body is different, telltale symptoms can be present in one person and absent in another, or they could be ambiguous: Strep throat could masquerade as something else; so could cancer.

With Veronica Pollack, it was a heart attack. Or so the physician at her local hospital thought. Chest pains radiating down her arms and certain out-of-whack cardiac enzyme levels, consistent with heart attacks, masked the real culprit: a viral infection. Several mistakes led to a wrong diagnosis, and several more mistakes -- and flaws in the health care system -- kept physicians clinging unquestioningly to that diagnosis for nearly a month.

Her husband, Harold, recounted the ordeal in his recent article "Lessons from an Emergency Room Nightmare." The story left AlterNetters in a frenzy, with dozens of readers trying to figure out how the mistake happened (was it physician arrogance? lack of creativity? lack of time?) and how similar mistakes could be prevented (increased physician attentiveness? more knowledge on the part of patients?). In an effort to get at the truth, some readers shared their own health horror stories.

Here's a sampling of what they had to say:

"My experience has been that many health professionals have a very arrogant attitude, both about themselves and toward patients," writes pelican beak. ... "I'm talking about the type of arrogance that doesn't listen carefully to the patient, jumps to unwarranted conclusions, and then doesn't look back to ensure they're not mistaken."

"I agree with Pelican Beak about the arrogance of physicians (as a whole, with some wonderful exceptions)," writes SpiderWoman. "But there is another problem that is well-demonstrated in this article -- a lack of creative thinking."

SpiderWoman continued:

The woman in this article had heart pain, so the ER doctors thought only one thing -- heart attack. It didn't matter that she'd had a viral infection or that she was an unlikely heart attack patient. Worse, though, is the fact that the doctors acted on their presumptions and proceeded with an invasive procedure -- one that was not needed, but placed her at risk.

This is much like my own experience, with the exception of an internist who was actually capable of real thinking and saw that this patient probably hadn't had a heart attack.

How did that internist figure it out? Not with tests or by reading the previous doctors' reports. Instead, he listened to the patient! That had not been done by any of the previous so-called specialists, who thereby missed the real issue, wasted time (days!) to get appropriate treatment to her and performed at least one dangerous and unneeded procedure. 

 

This is a major issue in modern health care, and arrogance is a major reason for its existence and continuation. 

 

 

TheLimit echoed SpiderWoman's sentiments, but with a caveat:

I think there's a strong sliding scale where arrogance is concerned. If you are clearly a well-employed, insured male, you are going to encounter much less arrogance than if you are a woman. If you are poor and uninsured, the arrogance will be in full force. If you are an elderly woman on a fixed income -- or a young single parent, you will generally see much more of it.

 

 

"Because I have bipolar disorder, my symptoms were completely ignored when I had reactions to medications -- I have had three requiring ER trips," writes DivaDeb. "One was to an anti-nausea drug that isn't used anymore (Compazine). I was told I was just 'keyed up.' I told them I know what manic feels like, and this is not it. They gave me a Benadryl and sent me home. I was a nutcase for over a day while that drug left my system -- I couldn't sit still, was twitching and was intensely afraid -- it made me temporarily semipsychotic."

See more stories tagged with: health, health care, misdiagnosis, diagnostic error, medical mistakes

Heather Gehlert is a managing editor at AlterNet.

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