Influential case #6

One month after the child died I described in “Influential case #5”, I was covering the emergency department at San Francisco General Hospital. An 11 year-old girl walked in at midnight with fever, headaches and a rash over her entire body. After taking one look at her, it was obvious she had meningococcemia, a horrible and often fatal blood infection.

Within an hour of her arrival, she had become confused and her blood pressure plummeted. Despite placing a breathing tube, starting antibiotics quickly and using four types of medicine to support her blood pressure, she died.

After she was pronounced dead, I was informed that she was seen at our clinic earlier in the day and diagnosed with a nonspecific viral syndrome. I went to the clinic and found the note from the visit. Immediately I noticed that the supervising doctor on the previous visit was one of my mentors, an amazingly competent and dedicated physician. I thought, “If doctor “X” saw the patient, there was likely no predicting that this patient would have meningococcemia”.

The following morning, my mentor was informed that the child died, and without hesitation, he/she slipped into a catatonic state and then began crying uncontrollably. There were no mistakes made and the care was truly excellent, but the supervising physician still felt tremendous guilt.

Moral of the story: Even if you provide quality care, adverse outcomes occur. At that moment, I stopped having debilitating guilt about “Influential care #5” and realized that I was involved in an unfortunate case and was not a bad doctor.

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