Category Archives: Medical Mishaps

When Things Go Awry: Making Sense of Medical Errors

Posted on by
8

Per the prompt for next week’s Grand Rounds, I’ve been thinking a lot about medical errors and what they do to the relationship between patients and healthcare providers.

Fortunately, I’ve never been involved in the type of medical errors that make the news, like wrong-side surgeries, items left in body cavities after surgery, lethal doses of the wrong medicine, etc. Thankfully, no one in my life has ever experienced anything of this magnitude either. But for every major crack in the system that makes the news, there are many tiny fissures that chip away at its integrity.

In my 28 years of patienthood, I’ve collected my fair share of mishaps and errors: The time I was forgotten about for 20 minutes after a barium swallow test, suspended in the air with my oxygen out of reach several feet away. The time that I was transported to radiology for someone else’s head CT scan, despite repeated protests that my lungs were the problem. The time I woke up during lung surgery (in the recovery unit I’d hoped that horrifying feeling had been a dream. It wasn’t), or the time a loved one was woken up and ordered to take pain medicine that wasn’t hers. I’ll leave delayed diagnoses and altogether wrong diagnoses for another day, because they are more nuanced, less obviously categorized, and especially in the case of delayed diagnoses, less split along lines of culpability.

(And of course there are the minor infringements and indignities: The blood draws that take 3 different techs and leave 8-10 bruises. The CT scans that aren’t where they are supposed to be for pick-up, or the mix-up with test results. Vials of blood dropped on the floor, cultures whose results get lost somewhere in translation, paperwork that is not filled out correctly, bills that belong to other patients that end up on my account…)

Though it relies so heavily on science, medicine is a profoundly human institution, never more so than in those moments when things go wrong. And like most human interactions when things go awry, the reasons usually include pure unintentional accident (who hasn’t pressed the wrong button, misplaced a slip of paper, etc), basic incompetence (there is a learning curve to everything), and what I think are definitely more damaging to the relationship, indifference and pride.

Personally, I am less interested in dissecting what can go wrong than focusing on what to do when it happens. In the macro sense, this could include improved safety protocols (like the checklist before surgeries) and other institutional safeguards. But I’m coming at this from the patient perspective, so I will leave those discussions to others.

No, what I am talking about are the more immediate reactions, how we treat each other when things don’t go as planned. Mistakes will happen but the mistakes themselves are not usually what bother me or stick with me, it’s the way they were handled.

(I recognize, of course, that it is because I have never experienced a major, life-threatening medical error that I can focus on this aspect of things.)

For example, in the wrong CT scan scenario I mentioned earlier, I received two very different responses. The person doing the scan became angry when I repeatedly told her I did not need a brain scan (as forcefully as someone in respiratory distress could), and became angrier when the same thing was told to her from someone higher up in authority. A vulnerable situation—not being able to breathe has a way of making you feel powerless—was made even more so by the fact that my voice was repeatedly ignored.

But moments later, the attending doctor apologized, told me he’d make sure the “patient has altered mental status” comment would be erased from my medical record, and checked in with me later to confirm with me the correction had been made and to apologize again. That’s what I needed—a simple apology and more than that, assurance that the mess had been cleaned up. In the exchange itself, what I needed was a few seconds of listening, an extra minute to confirm my patient ID, or basic recognition that someone who is visibly not breathing well might be onto something when she says it’s her lungs that need checking. I needed to be treated as a person, not a nuisance and not as someone who has absolutely no knowledge or insight into my own body.

If the mix-up had ended when I first got to the room (the transport orderly stared at my ID bracelet for a long time and somehow declared I was the right patient and that the number matched the brain scan patient’s) I would not have cared. After all, mistakes happen, especially in a busy ER. My ID would have been confirmed, I would have gone to get the imaging I needed for my own care, and the patient with the brain tumor would not be wandering around the hospital. It could have been cleared up in a couple of minutes.

But that’s the difference between accidents (reading the wrong number) and events that are the result of indifference or pride. Generally I try to laugh off some of these mishaps; after all, they make a good story and after all, everyone makes mistakes. However, what makes me angry or makes me resentful are the times when the errors are somehow shifted back to me. Whether it’s a doctor, nurse or lab tech doing that to a patient, a teacher doing that to a student, or a boss doing that to an employee (notice the trend here that skews towards issues of balance of power and authority?), it doesn’t make it right and it always damages the relationship.

It’s the same with smaller things like not getting my test results because my blood vials were dropped on the floor, or my name was entered in wrong, or the person who needed to submit form X did not do so. Just let me know and take steps to fix it and I’m on board with you; don’t get irritated with me that you now need to do more work, don’t act like I am an inconvenience to you when I am the one who needs to re-schedule work to come back in for the same tests I just had the day before because of your mistake.

Like every interaction, there are two sides and two avenues for conduct. The way I respond inevitably impacts how the situation resolves itself, too. I can accept the apology or not; I can be calm and reasonable or not; I can differentiate between an unintentional mistake and arrogance or indifference or not. These are distinctions I hope to receive when I make mistakes and errors that impact those around me (students, clients, etc).

Every profession, every interaction between people presents an opportunity for errors. Obviously the stakes are usually much greater when it comes to medical errors, but the basic rules apply nonetheless: Treat people with dignity and respect. Focus on fixing the problem appropriately and moving forward. Be forthright. Sometimes the hardest thing to do is simply say “I’m sorry.” Yet for (non life-threatening) errors, those two words can mean the difference between a blip on the proverbial radar screen and an event that damages trust and fosters resentment.

Monday morning links–Election info and the hazards of the diabetic test-taker

Posted on by
7

If you have chronic illness and read this blog, then you know why I think the health care vote is so important. (Check out my post on the female vote and health care for a quick refresher). Want more information? Check out this video on health care and the next president at vote.chronicdisease.org. Its message is compelling (and it also happens to be star-studded.)

While this next link doesn’t concern the election, I read this article this morning and had to link to it. As reported in today’s Boston Globe, a young woman with diabetes who was taking the GRE had her insulin pump mistaken for an iPod and was also told she couldn’t bring her testing kit and juice into the testing room. Check out the full story for details.

I can relate–it was a cold day in early November just a few years ago when my GRE proctor refused to allow me to bring my inhaler into the exam room with me (I was acutely sick at the time). Not the same situation, I realize, but certainly a similar fear of cheating that permeated the experience and overrode medical concerns.

Anyway, don’t miss your chance to cast your vote!

News, Updates, and 2007 At a Glance

Posted on by
3

Before I take a brief look back at 2007, here are some recent headlines to think about as we move towards 2008.

The relationship between Pharma and physicians is a complicated and often controversial one, and I’ve noticed a lot of media coverage about it recently. Check out this Slate article about off-label prescription use—it pits the instinct of the physician against the “industrial-government-insurance complex of medicine’s last quarter-century” and is an interesting read, especially if (like me) you’ve been prescribed medicines for off-label uses before.

In a different angle of the Pharma-physician phenomenon (oh alliteration, how I love thee), this Boston Globe article discusses tough new policies limiting the amount of interaction and influence drug companies have with doctors at UMass Memorial Medical Center. Sounds promising, but its feasibility is a consideration.

Now that I’ve taken stock of the last week’s headlines, it’s time to reflect on some of the headlines that have appeared on this site. Perhaps this retrospective indulgence is merely that, but with a tiny bit of hindsight, I think I would categorize 2007 as a year of awareness—of being aware of how chronic illness affects those around us, of being aware of what others are going through and what lessons can be taken from that.

There have been ridiculous tales of medical mishaps and comic calamities (okay, I will stop with the alliterative abundance here, but who said anything about assonance?), and plenty of new voices who have made me laugh and impressed me with their grit.

There have been moments of profound grief, at once intensely personal and wholly universal, as well as moments of humility in the face of someone else’s pain. I’ve realized how much I owe the healthy one in my marriage, and how precious timing is when it comes to the people I love.

I’ve looked at books and the process of storytelling itself for inspiration and understanding. I’ve had some personal highs and I’ve only been in the hospital a few times, a different kind of personal high indeed.

From gluten wars to medicine and politics, it’s been a busy year for acknowledging and understanding disease and its many manifestations in our lives.

May you all have a happy and healthy 2008!

This Old House (The Body Edition)

Posted on by
6

I spent much of the day yesterday on a train to New York (because obviously the only thing more sane than moving three days before Christmas and becoming displaced for three weeks is squeezing in a last minute business trip the day before said move, but it was well worth it. When have I ever been known to do things in any sort of logical, tempered manner, anyway?)

I was wading through some research for a project I’m working on, but despite how interesting I found Kleinman’s theory of sociosomatic illness (and I really did), I couldn’t string together two coherent sentences on it. For one, my body was achy and tired from packing boxes, stacking them, and packing some more. My brain was whirring with logistical details—movers, lat minute requests from our buyers, Christmas gifts that needed purchasing—that kept creeping into my highlighting and note-taking routine.

But more than anything, the New England coastline makes for a pleasant distraction. The only thing I found more enjoyable than looking at the icy waves and scenic vistas was looking at all the different types of homes that dotted the shoreline.

True, I have moving on the brain, but I have always been fairly obsessed with old houses. This train ride gave me plenty of chances to feed my fervor. Really, is it surprising that the structurally defective girl likes houses with wonky hardwood floors, sloping corners, and squeaky joists? No sparkling new boxy Neo-Colonials with their pristine, virgin floors and sensible open floor plans for me. If there aren’t systematic idiosyncrasies—or what I prefer to consider charm–I’m not interested.

Part of this is situational. I grew up spending the summers on Cape Cod in a neighborhood where most of the houses were grand rambling affairs, circa the 1700 and 1800s. Most of the places I’ve lived in the city have been old—in Boston, this comes with the territory—with crooked angles, oddly shaped windows, and steep staircases.

One of my goals in life is to someday own a house with a turret. As long as the turret is accompanied by a creaky old front porch for Scrabble playing, my husband is on board with this. But besides the geographical aspect, I think I just have a more finely attuned appreciation for large-scale quirkiness.

My middle fingers have broken so many times that sometimes they just get stuck in the bent position and it is impossible to wrench them straight again. When I am fading, apparently my left eye doesn’t open as much as my right one, a bizarre little factoid my husband uses to gauge my energy level. I routinely get high fevers for no obvious reason. I can predict changes in the weather by the thickness of my lung secretions, and I’ve been known to grow bacteria not normally found, oh, say, in North America.

And when it’s humid out, my curly hair actually grows more horizontal by the minute (I have witnesses), just like a real, live Chia pet. Good times.

I’d like to say that like the old houses I adore I have good bones; however, we all know that would be an outrageous lie. But like an antique Cape coming out of a long, stormy winter, I like to keep things…interesting.

Thank goodness my husband likes long-term maintenance projects.

And turrets.

***

In all of the holiday madness, don’t forget to swing by Medgadget to cast nominations for the annual Medical Blog Awards.

I’ve Been Told I Need a Bubble….Can I Make that Two?

Posted on by
3

After all these years, dear readers, I can safely say I’ve encountered a “first.”

I tore a ligament in my ankle. Sitting still.

Yes, sitting still. Now, I’ve torn, broken, twisted, and battered my knees and ankles many times; I’ve even had the other ankle surgically reconstructed using a tendon from my leg that was strategically drilled into the bone and held in place with pins. But normally, there are reasonable explanations for my injuries: a wrong turn in kickboxing class, a stumble off a sidewalk onto cobble stoned streets while wearing heels, too much wear and tear from figure skating as a child, etc.

Now imagine my sheepishness when I hopped/limped into the ER at 1 am last week and had to answer the inevitable, “So how did this happen?” What else could I do but admit the truth: I am that much of a disaster that even sitting still I somehow manage to injure myself. I mean, I thought I’d reached an all-time low when I broke my finger typing last month (the second time I’ve done it that way), but at least I know I can still surprise myself.

For years, friends and family have half-joked that I need to encase myself in a protective bubble. In fact, even my doctors have said it. Whether it’s a strep infection in my knee, a rare type of bug no one else grows, the time I broke into hives only to be told I’d somehow become allergic to myself (I’m not kidding on that one), or any of the other myriad medical mishaps I’ve encountered, each time the tale borders on the improbable, the response is the same: “You need a bubble.”

Actually, I think I need two.

Allow me to contextualize this most recent escapade. I was sitting on the floor of my parents’ bedroom, legs on the plush rug and back leaning against the bedpost. My dog had her head resting on my left ankle, which was turned outward. After a few minutes, my ankle felt sore but I was reluctant to move it. I remained that way for about an hour and when I finally stood up, I fell over and my eyes smarted with the pain shooting up the side of my ankle, into my heel, and up my leg.

But silly girl, why didn’t you just move your damn foot when it started to hurt?

Ah, but don’t forget, I ordered two bubbles. The other one is for my similarly cursed dog, who was resting her lamp-shaded head on my foot and howling piteously in pain. You see, we’d just gotten back from an emergency animal hospital where she’d had a 4-inch long, 1-inch wide plank of wood removed from her right eye.

Yes, my dog had a plank of wood stuck in her eye. Well, to the side of the eyeball itself, where it sliced through her mucus membranes and sliced all the way back to the bony orbital near her brain, narrowly missing her optic nerve. At one point, we didn’t think she’d even be able to keep the eye, but she did.

It was a hideous sight, opening the back door and finding her sitting there waiting to come in, this huge stick in her eye. It didn’t even look real.

Who was I to move an animal in clear agony? And really, whose feet don’t get uncomfortable in certain positions? Even I couldn’t have guessed I’d actually hurt myself sitting there.

(Side note: she wound up going back to the hospital as an inpatient for four days and is just now starting to make a very slow recovery.) (Side note two: caring for two dogs, one of whom requires constant attention and has more meds than I do, while on crutches and painkillers, is not ideal).

I got a phone call yesterday and the person was surprised to hear me so hoarse.

“Isn’t it your ankle that’s hurt?” she asked.

“Yes, but I’ve been sick with a respiratory infection for five weeks now. I just forgot to mention that with everything else going on,” I said.

I had to laugh a little at the fact that this didn’t surprise her in the least.

So yes, I need two bubbles. One for me since obviously I can’t get out of my own way, and one for my panic-attack prone, anxiety ridden, severe food allergy suffering dog who was doing what she loved best—racing around the fenced-in yard with her best friend—when somehow she practically impaled her own eyeball.

She’s resting her swollen head on a pillow right now, and as I type, I’m elevating my swollen ankle. We definitely deserve each other.

Most. Humiliating. Experience. Ever.

Posted on by
18

“Oh, hey, good luck with that phlegm.” (Said in the most insincere, mocking way imaginable.)

“Thanks a lot, jerk.” (Said in most indignant, shocked way imaginable).

And with those parting words at baggage claim, thus ended the most humiliating, awful experience I’ve ever had in terms of being a patient. Even several days later, my face flushes in anger and my heart rate quickens a bit.

Let me start at the beginning. My husband and I were returning from a weekend trip, a Thursday night to Sunday affair. We brought The Vest with us, as we always do, and we brought it as a carry-on item, as we always do. It cost nearly twenty thousand dollars, so we’ve never wanted it rolling around underneath the plane, and we’ve never had trouble stowing it above us. This time, our plane was a tiny commuter plane, the kind with only about 20 rows and midget-sized overhead compartments. The gate attendant Thursday night said our backpack might not fit overhead (which it did) but that The Vest would.

It didn’t. So we stowed in beneath our feet and while it did protrude about an inch or so, I still had room for my feet and the flight attendants made no mention of it. We did the same thing Sunday, figuring on the same airline and on the same type of plane, what passed muster Thursday would be okay Sunday.

It wasn’t. I should also add that by the time we were on board and stowing carry-on luggage, the plane had already been delayed by 35 minutes and we were still third in line for take-off. The flight attendant and a customer service rep told us that it wasn’t far enough under the seat and we’d have to check it. My husband asked if it would be insured if we placed it underneath the plane and something happened to it. We were told that it wouldn’t be because it wasn’t checked originally, and that we should have made alternate plans if we wanted it insured. We pointed out that we would have made other plans if we hadn’t thought we could bring it on the plane the same way we just had days earlier, but handed it over anyway.

The whole exchange lasted about three or four minutes. People on the plane were getting antsy—one man even pointed to his watch and said he had places to be—and I don’t blame them, but it was the airline’s inconsistency that caused the problem. I was mortified and really self-conscious the whole flight, even though we were still delayed several minutes while the backlog of planes in front of us departed and all of that had nothing to do with our four-minute exchange. Still, the whole plane knew I had a piece of medical equipment that needed to be moved, and that’s the kind of public notice I don’t like.

I had recovered by the time we were at baggage check. In fact, I was resting on a bench when I saw a man approach my husband and get in his face. Seriously. In his face.

“Hey buddy, we’re cool. It’s cool. I mean, I got my car towed because you wouldn’t check your bag, but really, it’s ok,” he said, shouting.

Because I am a hot head and because I didn’t like this guy yelling at my husband, I got in the middle of them. They were going back and forth, the guy (who was there to pick up his girlfriend) screaming that we should have made other plans and John explaining that the 35-minute delay prior to boarding is what made us late.

“You don’t know anything about our situation. We were allowed to bring it on the other day. It only took a few minutes to check it, and we were still third in line for departure, so it didn’t make a bit of difference in terms of when we took off,” I said.

John chimed in with, “It’s an expensive piece of medical equipment that helps keep my wife alive. It keeps her from drowning in her phlegm.”

“I’m sorry to hear that,” the guy said. For a second, I thought he meant it. “But hey buddy, say my girlfriend has a health problem, I wouldn’t be able to take her to the hospital because my car got towed. If I hadn’t been waiting twenty minutes, I’d have a car, but it’s cool, I mean as long as you feel you don’t need to check your bag.”

“Wait, you parked your car in a tow zone and left it alone for twenty minutes and it’s our fault you got towed?” John asked incredulously. (At that precise moment, the airport security message warning that all unattended vehicles would be ticketed and towed immediately came on. It was too perfect.) “The plane was late before we even boarded it, so don’t put that on us. And don’t park in an illegal area and leave your car alone and then scream at me for it!” John added, motioning in the air towards the intercom.

All three of us went back and forth a bit longer, voices raised and faces red. When the guy finally walked away and spat at me“Good luck with that phlegm” several times, very loudly and meanly, I was shaking. Literally every muscle in my body was quivering, not from anger but because no one had ever made me feel so terrible. The way he yelled it at me in front of so many people basically felt like he was saying, “Die for all I care, my car got towed.”

I sat down on the baggage claim carousel to steady myself.

I regret so many things about that whole incident: I regret the airline’s inconsistency put us in the position of risking a twenty-thousand dollar piece of medical equipment. I regret that both of us lost our cool and raised our voices in response to this guy, something I have never done in public and hope to never repeat again. And I really regret that after everything I’ve seen and done, some jerk still had the power to make me feel like my existence was so inconvenient and worthless.

And I will never, ever fly on a certain airline named after the fourth Greek letter again!

Stranger than Fiction

Posted on by
7

Given my journalism background and current state of intense nonfiction book writing, I sometimes forget I applied and entered my MFA program as a fiction writer. I haven’t had much chance to indulge in novels lately—whenever I am not writing my book I am researching material for it—and miss the crafty details, the intricate plot lines, and imaginative twists and turns.

Life, however, never fails to give me fodder.

The truth is often stranger than fiction, and all I can say is that I couldn’t make this stuff up, and if I did, no one would take me seriously.

Last week, my grandmother had a series of strokes. This alone is a decidedly serious, difficult, and emotionally draining situation and worthy of its own post (forthcoming). But things are never that singularly difficult in my family. Thankfully, my (severely arthritic and debilitated) mother and my (walking disaster of medical conditions and recent cardiac surgery patient) father were on Cape Cod with her when it happened and could take her to the hospital.

Clearly this was a stressful time, especially for my grandmother and my parents. They spent hours in the ER, waited for multiple tests, and got the grim, scary news that she has a large brain aneurysm. Thus the whole rehab-nursing home machine began churning.

Enter the ridiculousness. The week before, my father got a sunburn on the top of his foot. By the time he was at the ER with my grandmother, he could barely stand on it. Whether it’s because he’s been an insulin-dependent diabetic for twenty years and doesn’t heal fast or because he’s predisposed to infections as a result of his immunosuppressive meds and chemo or just terrible luck, the sunburn turned into a staph infection and cellulitis.

After IV treatment, my mother brought him to their vacation house to rest and quickly returned to the hospital to be with my grandmother. They had to leave his car at the hospital and my mother, whose shoulders aren’t up to lots of driving, did all of the ferrying back and forth.

And then their land line shorted and they had no dial tone. My father had dropped his cell phone in the ocean the weekend before so he didn’t have one. My mother had forgotten her charger and her cell phone was dead. Because the phone line was faulty, the security system went haywire and kept beeping.

And then my father realized he couldn’t rely on his his crutches because his arm muscles were too weak from his polymyositis. This meant he couldn’t get up to use the restroom or get any food, and my mother couldn’t help him when she was home because her back was too unstable. I should add there wasn’t any food in the house anyway since my parents hadn’t expected to stay through the weekend.

Just to recap: a temporarily immobile diabetic with a potentially life-threatening infection was alone in a house with no viable way to communicate with the outside world and no access to food should he become low.

Did I mention the heavy rains caused the basement to flood?

“Can you come down and get your father lunch?” my mother asked in her harried state, really asking for so much more.

So I packed up my clothes, medicines, The Vest, and the dog and took off for the two-hour drive. For the next couple of days, I shuttled between my grandmother’s room in the stroke wing and the outpatient clinic where my father had to return each day…all of which wouldn’t be all that ridiculous except for the fact that the humid weather made my congestion a lot worse so pushing my father’s wheelchair while juggling my bag, my laptop, and his briefcase was a scene of its own.

The only things that saved us all was the fact that we never lost our electricity during the thunderstorms—my dad could watch TV since he couldn’t do anything else, I could plug in my Vest and hope it worked since I forgot to pack my nebulizer, and when my mother returned home from her long days, she could use her heating pad…and the fact that after a lifetime of illness, we weren’t derailed by it all.

“That’s just the way you guys roll,” my physical therapist said when I summed up my tale.

We both laughed. It sure is.

Posted on by
3

Body Confidence: How Mutinous Bodies Influence Our Instincts

To be fair, I had warned the nurse trying to insert an IV into my arm that I was a “bad stick.” While that is the understatement of the year, I hoped it would let her know that the problem wasn’t her, it was me. Or, as I liked to say, my wily, conniving veins. I needed an ACTH stimulation test to check my adrenal glands. It should have been a simple procedure—draw blood, insert medicine via IV infusion, re-test blood one hour later.

Looks like I may have jinxed all of us that day.

One hour and 45 minutes, 14 sticks, eight blown veins, several hematomas, multiple heating packs, a couple of additional phlebotomists, and much teeth-gritting later, the nurse wouldn’t even come back into the room and I still didn’t have an IV line started. At first, I tried to crack jokes and smile a lot so the nurse—I’ll call her Tammy—wouldn’t think she was hurting me. I have a pretty high pain tolerance (I get my cavities filled without Novocain), but even I will admit that it did hurt.

“No really, it’s okay, you can keep going,” I told her when the needle went into yet another vein and no blood came back out. She’d push and prod until the vein blew or else swelled up to the size of a golfball. After a few tries, she called in the phlebotomist, and an interesting turf battle transpired in terms of tactical approaches. After awhile, Tammy got even more rattled watching over her colleague’s shoulder, and she left the room altogether.

“I don’t understand. I do these all the time, but now I’ve lost my confidence. I don’t want to go near you, and I don’t want to hurt you,” she said as she left. She was practically in tears.

I never got my IV. They had to push the medication in all at once with a syringe and then re-stick me for the second blood draw an hour later. I left with 15 band-aids, several very sore and swollen patches on my arms, and a few instant heat packs to tape around my arms later in the day.

I looked like a disaster, but I honestly think Tammy came out of the experience more troubled by it. “I just don’t have any more confidence in my ability to put in an IV,” she said as she gave me my parting instructions. I was struck by how the balance of power had been disrupted by some tiny, stubborn, and scarred veins. I tried to comfort her with assurances that everyone struggles with my veins, but it didn’t help.

Being the patient trying to console and bolster my healthcare provider was an odd role reversal, but one I’d experienced before. Whenever my body doesn’t act the way it needs to, I feel responsible to remedy the discomfort it causes, like it’s somehow my fault that people lost confidence in their skills when left alone in an exam room with my complicated medical history and my uncooperative body.

But I could relate much more to Tammy than I’d have guessed. I am used to temporarily losing confidence in my own body and in my own skills as a result of my various conditions. It’s the worst when I am returning back to a more “normal” schedule after a prolonged absence or exacerbation. I begin to doubt what I can do, question my stamina level, and hesitate in making plans or commitments because I am not sure I can trust my body the way I once did. Eventually I get there, but while it happens, it is a terrible feeling to question my own instincts, the same instincts that have proved so wise in the past.

I see now why that IV scenario was so precarious for both us. Tammy and I each have our expertise—hers as a nurse, mine as a patient—and yet my body managed to make our knowledge backfire for both us that day. Goes to show that no matter how much you think you know, illness is always an equalizer.