In First Opinion this week, Vonda Baden Bates wrote a heartbreaking personal essay about the death of her husband, Yogiraj Charles Bates. He died from a post-surgical complication, venous thromboembolism (VTE), in 2012. "After a few days, even though he was walking frequently, Yogiraj's symptoms of numbness, chest and leg pain, difficulty breathing, and fever created worry," she writes. "Though the practitioners were kind and attentive, they failed to diagnose Yogiraj's symptoms as signs of a blood clot, and they didn't communicate well with one another."
What I love about Vonda's beautiful essay — published on the occasion of the launch of the Core Elements of Hospital Diagnostic Excellence project — is the emphasis on the kindness of the care team that missed Yogiraji's VTE. "Yogiraj might have survived if we had not confused kindness with skilled, quality care. I slept in the hospital with him all 12 days of his hospitalization, and every time we spoke of a symptom, the care team listened, but I should have been more insistent," she writes.
So often, I think that the discussion about medical error presupposes that mistakes are a result of carelessness or disregard. As Vonda makes clear, her husband's doctors cared and listened — but the system failed them as well as Vonda and Yogiraj.
Also in First Opinion this week: Maria D. Van Kerkhove, interim director of the Department of Epidemic and Pandemic Threat Management at the World Health Organization, writes that getting vaccines to the centers of the mpox outbreak in Africa is only the first step. Infectious disease doctor Mark Siedner and former CDC Director Rochelle Walensky argue that the way pharmaceutical companies conduct clinical trials for HIV treatments on young women from Africa is unethical. The "forced swim test" for mice is a terrible way to model depression. Elizabeth Pfiester, founder of T1International, says that it's impossible for advocates to work with drug companies. A New York City pediatrician sounds the alarm about a large health system changing new-patient visits from 40 minutes to 20 minutes. Medicaid must prepare now to cover twice-yearly HIV prevention shots. It's time to remove DEHP, a cancer-causing chemical, from IV devices used to treat cancer. And the large doctors' protests in India are missing something key.
The First Opinion Podcast will be back in a couple of weeks, so let me know what people you want to hear from and what topics we should discuss.
Recommendation of the week: I'm currently re-reading "The Country of Ice Cream Star" by Sandra Newman, a novel set decades after the U.S. is hit with a disease that kills everyone over the age of 21 or so. The first half is written in Newman's approximation of how language might evolve when society is dominated by teenagers and generations turn over rapidly. It's lovely, though sometimes difficult, reading and goes places you might not expect. Also, I need some more books to read. Please send me your best middlebrow recommendation — I don't have the energy for anything too highbrow at the moment.
P.S.: If you're not a STAT+ subscriber, I've got some great news for you: Until Sept. 26, you can get your first three months for just $20. Sign up here.
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