We All Make Mistakes

The good old Hippocratic Oath

The good old Hippocratic Oath

How many times have you heard a story whereby a patient was misdiagnosed; a doctor missed a cancer diagnosis altogether; or a patient unwittingly ignored or dismissed certain symptoms and subtle warning signs? Unfortunately, we have heard this story one time too many.

There are numerous causes of misdiagnosis. But whatever the cause or reason may be, in many cases, these mistakes can lead to catastrophic consequences.

Take my case, for instance. Given my extensive medical history (there are literally volumes and volumes), it’s not surprising that I receive much needed preventative screening and close observation. However, because of my age and the fact that doctors sometimes feel as if they do not want to overburden me with unnecessary worry, there have been instances whereby nothing has been done or no tests were ordered.

About a year before the osteosarcoma in my neck was discovered, I had noticed both a small bump on the right side of my neck (where my original rhabdomyosarcoma at the age of 3 was located) as well as some pain in the area. It felt as though I had pulled a muscle in my neck. I was worried by the discovery, as is any cancer patient whenever they spot a new bump, pain, or change. I knew I had to have this examined further. There is an after care clinic set up where childhood cancer survivors who are now 18 years of age or older are to be monitored for possible late-term effects of pediatric cancer. As opposed to notifying my family doctor of any inconsistency or irregularity, I would notify the doctors at this clinic.

At my follow-up appointment at the clinic I mentioned the bump and pain that I was experiencing on the right side of my neck. I wanted to have an MRI done just to rule out any abnormality (this is code for I wanted to make sure that I didn’t have cancer). However, I was told “you can’t worry or think you have cancer every time you notice a bump or feel some pain.” And although this may very well be true for many people, knowing what I know now about my situation, I would beg to differ.

The doctor very briefly looked at my neck and concluded that it was probably a pulled muscle but that it was nothing to worry about, and said that an MRI was not required. In all sincerity, I should have pleaded and pushed the issue further that day, but having had cancer four times prior to this, there was something calming and very reassuring about hearing a doctor who specializes in cancer tell me that “this was nothing serious, nothing to worry about.” Although part of me still worried, I entrusted the doctor with my faith, and I went on my merry way.

Several months later, the pain intensified and the bump grew larger. Panic mode now sunk in. Although the doctor said this was “nothing,” I couldn’t help but feel very apprehensive and unnerved by the situation. I kept thinking that a pulled muscle would have gone away and would not have caused this bump to grow larger. So, after waiting a few weeks for an appointment (which was another huge blunder), I was finally able to be seen at the clinic. This time I knew for sure that I required an MRI, no matter what. I explained how the pain was much more intolerable now, it almost felt as though I couldn’t hold my head up anymore. It was a constant throbbing pain. Not to mention that to me (and everyone around me) the bump had become visibly larger. It looked like I had a second head growing out of the side of my neck. Seriously, this screamed out TUMOR! The doctor looked at the now irrefutably large bump on the side of my neck and said that it did not look bigger than the last time. The doctor still maintained that it was most likely “nothing to worry about,” but that given my insistence on wanting an MRI, as well as to help put “my mind at ease,” an MRI was ordered.

I am sure you can all guess how this story ends. Not the way a Walt Disney fairytale ends, that’s for sure. Unless there’s going to be a new Disney movie whereby the princess has a huge freakish bump at the side of her neck that is presumed to be ‘nothing,’ but is later found to be an incurable form of osteosarcoma. I can just see it now “Cancerella.” So, there you have it, “mistakes” happen. And some of them can be deadly.

Was this “mistake” considered “negligence”?

Flashbacks of law school all over again.

Flashbacks of law school all over again.

Negligence is a fancy legal term used in tort law to describe a failure to exercise the care that a reasonably prudent person would exercise in similar circumstances. It is not intentional harm, but rather carelessness. Not every mistake or bad decision can be categorized as negligence. Essentially, the key issue is whether the doctor made a reasonable decision, one in which other reasonable doctors would have made in the same circumstances. In such a case whereby a doctor made a reasonable decision, this would not be considered negligence even if the decision turned out to have been a bad one, which in turn led to a bad result. Basically, a doctor may take all of the right steps and still make a mistake or end up with a bad result. In my case, I do not believe that it was reasonable for my doctor at the time to conclude that given my extensive medical history and previous cancers as well as the symptoms I presented with, that I did not require an MRI. To me this decision was an unreasonable one, and it fell below the necessary standard of care that I was entitled to (and should have received). However, having said this, in retrospect, it seems pointless to obsess over these details now. What does this accomplish? It does not change my situation in any way, as it is too late for that. If anything, it makes matters worse, as it adds unnecessary stress and utilizes too much energy that is better directed at trying to heal myself.

It’s imperative to note that there are many cases of negligence and misdiagnosis in Canada that result in injury and death. However, these patients face huge challenges in obtaining just and fair compensation for their injuries. Navigating the legal system requires time, energy, expertise, and money, all of which unfortunately make it prohibitively difficult for these patients who have suffered injury to be vindicated. Not to mention the very deep pockets of the Canadian Medical Protective Association. So very often these claims are abandoned or go unreported altogether.

Turning back to my case, had an MRI been ordered when I first complained of pain and noticed the bump on my neck, most likely the cancer would have been detected then and therefore it would not have been an advanced or fourth stage cancer. This will forever remain a mystery. Despite the fact that I was furious at the doctor’s complacency, as well as furious at myself for not being more aggressive and accepting such substandard care, I have since accepted the situation for what it is. I am now trying to deal with the consequences by moving on in the best way possible. In the words of the renowned poet, Alexander Pope, “To err is human; to forgive, divine.” In effect, as human beings, we all make mistakes. We are nothing more than mere mortals. We do not possess godly powers or attributes. And we falter and fail. I would be lying if I said that it has been easy to forgive some of these failures and “mistakes,” especially ones that have caused me great harm, and may even be the cause of my death. But in the end, forgiveness is the only thing that will allow me to move forward. I will be extra vigilant from now on towards my healthcare; however, I too may make a mistake along the way.