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Urology Pearls: TO ERR IS HUMAN – part 1 of a series

Shahar Madjar, MD

My brother’s second wife, Hannah, was of Moroccan descent. She and my brother, Israel, lived only eight miles away from our home. Their apartment was small and always under construction. Israel, an electrician by profession, completed the electrical wiring within the first year. He then decided to paint the apartment. A big mistake. He divided the walls into many sections, and painted each in a different color. Window frames, doorways, chairs, desks, kitchen cabinets, bed frames, and headboards–he painted each of them in a different color. He cared deeply about straight, perfect lines. Even a small paint smear would send him starting all over again. Hannah lived in a world of brushes and paint buckets. Her home was as colorful as a nightmarish rainbow.

I appreciated Hannah for her love towards Israel, for her patience toward his painting, and for her cooking. When we came to visit, we sat around the blue table, each of us on a chair of a different color. And Hannah would serve her Moroccan-style spicy fish. The taste was divine, the texture perfectly flaky. We broke our bread and dipped it into the rich, hot tomato sauce. Heaven.

I didn’t know much about Hannah’s family until she called me one day, her voice breaking. “It is my mom,” she said, crying, “she is at your hospital, at the Department of Internal Medicine, and she isn’t doing well at all. Can you go see her? Can you talk with the docs there?”

The year was 2000. I was a resident at the Department of Urology, not at the Department of Internal Medicine. But I knew the doctors who worked there. “Of course, Hannah,” I said, trying to recruit the most calming voice I could muster.”

At the time I knew little about Israelis of Moroccan descent. I knew Hannah, of course. I also heard a few jokes about Moroccan Jews. You see, Israel has been a melting pot of cultures. Jews have arrived from Europe, Asia, Africa, and from everywhere else. The term ‘Politically Correct’ had not yet been coined. And so, with each new wave of immigration, a new set of jokes came to life about the newcomers–stereotypical, mean-spirited, and, of course, false. The stereotype of the Moroccan family was that of a patriarchal family blessed with many children. The patriarch was caricatured as a hot-headed individual who would pull out a knife and resort to violence if things weren’t going his way.

I checked on Hannah’s mom and talked with her doctors.

The waiting room was packed. Hannah’s family was all there. Brothers and sisters, uncles and aunts, a lot of children, Hannah’s father, and, of course, Hannah herself. I was standing there in front of them all. Hannah held my hands waiting for my words to come out. The elder brother, Eli, introduced himself. From that time on, he did the talking, “So, doc, what’s happening, doc?”

“I’m afraid,” I said, “that I don’t have any good news. It isn’t good, the situation, I mean. She isn’t doing well, your mom, in fact, they had to intubate her, and she will be transferred into the ICU, the Intensive Care Unit, I mean.”

“But how can it be, doc?” Eli said, his voice tinted with anger, “she was all fine when we brought her in. Walking. Breathing. Talking. And now you’re telling me that she can’t breathe?” He looked me in the eye and he didn’t blink at all. He seemed upset, becoming unhinged. “Someone must have f@$#ed up, doc,” he said.

It took a while to calm down the spirits. I took Eli and Hannah to my room at the Urology Department. I told them about Hannah’s mom, the woman they all so deeply loved. “She was walking, and breathing, and talking when she arrived at the hospital. That’s true. But she has been a heavy smoker, and had diabetes, and hypertension. And she came to the hospital for a reason. Her chest was hurting. It was a heart attack, and then her heart failed. I am sorry. I really am.

“Every doctor makes mistakes,” I told Hannah and Eli, “but in your mom’s case, no mistake was made. Her doctors are good. They made the right diagnosis. They treated her by the book. It is the human condition,” I told them, “we are here for a while, and then we leave this world. And in most cases, it’s nobody’s fault.”

Eli and Hannah looked at me, tears in their eyes. During that night, Hannah’s mother passed.

This is the first in a series of articles about errors in medicine. I told you the story about Hannah and her mom, and I wanted to say: doctors make mistakes, but medicine, with all its faults, extends, rather than shortens life. To err is human. But to be born into this world, and to leave it, naturally, is human too.

Editor’s note: Dr. Shahar Madjar is a urologist at Aspirus and the author of “Is Life Too Long? Essays about Life, Death and Other Trivial Matters.” Contact him at smadjar@yahoo.com.

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