Errors in Medicine
It is gruesome, just the thought of it, if a man/woman with the intention to heal another of a disease, manages to effect the opposite. One is talking of a scenario in which a man has spent a third of his life-time of three-score-and-ten to master a career, and let’s take in this example, the medical field, and he manages at times to effect the reverse of what he initially had in mind to do, and it may result in the maiming of his victim, or at times, even worse, he passes the death sentence on him or her, the target. In ancient times, the laws of some empires had situations like that strictly examined, and when negligence or “avoidable mistakes” were detected, punishments were handed out to the Medicus or the doctor, “codex Hammurabi”. But, doctors then posthumously, millennia later, should win the admiration of the people they served. There was no X-ray machine; there was no Ultrasonography; no CAT-Scan, and of course, no MRI-machine either. The man in the healing art has existed ever since recorded history. But, should you be a man or woman who relies so much on modesty, take the last five thousand years. The man who lived in the Nile basin of Phoenician or Nubian origin, found a way of detecting Pituitary lesions, and yet still, a way through that “sensitive locus”, the nose (a method used even today, at times by the Brain Surgeon in handling Pituitary tumors). How was the lesion then detected? Your guess should be as good as anybody else’s. But, for sure, the records show (archives from the Alexandrian Library) that surgeries such as Gall-bladder for the removal of stones in addition to lesions of the brain were carried out. The discovery, per Serendipity, of the X-ray by Conrad Roentgen (1896), was such a landmark which changed the practice of medicine, especially Surgery, in a way that could not possibly be imagined previously, nor was that all. Almost one hundred years later, in 1972, Geofrey Houndsfield, an English Physicist, took the world by surprise with yet a breakthrough. The CAT-Scan, an electromagnetic energy-form, which sent Roentgen’s discovery, “three dimensional”, was soon to follow. The Magnetic Resonance Imaging (MRI), which was to follow in less than ten years, took the medical world yet a step further, and so soon, dare not be looked upon as the end of that development either. So, where would the justification come from that the Medicus still continues to make mistakes? Accidents or negligence, or what is dubbed as human error, because it would seem more acceptable that way. Look at deadly rates of complications, oftentimes expressed as “mortality rates.” The fallacy is that improvements are registered, as we refine the methods, and some parts of the world may commit more mistakes than contemporaneously. Another example could be drawn from the South African experience during the mid-sixties that continued for two decades. Prof. Christian Barnard in Cape Town, South Africa, repaired malformed or “corroded human hearts” faster than the VW motor car manufacturer in Germany turned out “the little bugs” in a minute some forty years ago. Today, human hearts may be repaired or transplanted virtually in any corner of the world. Some parts of the world make more mistakes than others in this connection, though. To open the human brain had been looked upon as a taboo for millennia. The Akans of Ghana expressed it this way: “Unlike the papaya fruit, the human head dare not be opened up for the fun that it may offer.” It says it all. It is nevertheless no longer such a big deal to open the human brain and repair essential parts in it, in times of disease or trauma. Having said that, the Neurosurgeon may be required to answer questions, the same way a motorist might be asked, who might be accused of “careless driving.” How do the two compare? Both may lead to disability, or death. Do many people recollect the saga of the “pop-music chief”, whom the world lost some two years ago, and the “indefensible situation his long-term physician was put into?” In quintessence, the “advanced-technology” laboratory equipment, or the MRI-machine may deliver the Medicus every diagnosis par excellence, some lethal consequences that should be regrettable seem to occur on a daily basis nevertheless. Aircraft crashes were more frequent decades ago than today, in spite of a million fold increase in passenger statistics. It seems much safer to fly to the planet Mars, than to fall under the knife of the Surgeon. This is a comparison that the Surgeon would like to see changed, in his own interest, as well as that of the community he serves. Would that possible? Yes, indeed!
Kofi Dankyi Beeko, MD. Consultant Neurosurgeon
Short URL: http://thechronicle.com.gh/?p=48266