Disaster diagnoses and bone tumor tragedies (Can't none of us be perfect, right?)
There’s nothing more demoralizing than failing in your job. It’s a reality all of us face daily. (Can’t none of us be perfect, right?) And when we do screw things up it’s enough to send you under the covers for a long bout of escapist slumber.
That’s what happened last night after I learned of last Saturday morning’s misdiagnostic mishap. Yeah…I missed it. Here’s the scoop…
While all of you were having a good time sleeping in I was fielding a waiting room full of unhappy emergencies in advance of Memorial Day’s obligatory shut-down.
Among my patients, a dog of indeterminate breed with three earthbound legs. The fourth one, a hind limb, didn’t deign to touch the floor throughout the entire visit (nor indeed since the previous evening’s walk).
Feeling up the afflicted leg for signs of discomfort and instability, I found his knee especially ouchy. Unable to manipulate it due to his pain and anxiety, I gave the guy a break and eased up on the power-exam.
Because we were so extra-busy that day, I discussed the concept of a cruciate ligament tear as the most obvious culprit. Reasoning that such an injury required a surgical consultation ASAP, I explained that I was short-staffed and asked if they would mind waiting for the surgeon to take the necessary X-rays.
Agreeing readily, my compliant clients went home with instructions for strict cage rest, a few high-powered pain relievers and an appointment on Tuesday to see the specialist. Sounds like it should’ve been a job well done, right?
Not exactly. Tuesday closed with a phone call from the surgeon informing me of the likelihood of a bone tumor about four inches down from the knee. So much for my discussion of cruciate disease. I wasn’t even in the same anatomic zip code.
The worst? On Saturday I wasn’t even together enough to give my normal spiel on the list of different possibilities for knee or near-the-knee pain.
Cruciate. Cruciate. Cruciate. Yeah, usually this mantra holds for me (truly, I’m not often wrong on so simple a diagnosis). But bone tumor is an obvious alternative I will typically mention—especially when the pain is on the heavier side.
Of course the surgeon tried to make me feel not too badly about it, using words like “subtle” and “barely perceptible.” But I knew better and said so.
His take? A sunny, “But you still did right by the patient. He wouldn’t have gotten any better care had you been more meticulous in your examination and your explanations. And you won’t make the same mistake again, right?”
My answer? A grumbling, “At least not this week.”