A Doctor's Apology Can Heal

A few days before my mother died, her primary doctor asked to speak to me in the hall outside her hospital room.

I pushed myself out of the chair beside my mother's bed, where she lay unconscious and tethered to oxygen. Why not? The doctor couldn't possibly have more awful surprises. My mom already had lobbed the worst of those grenades — and weeks before her doctor had figured it out.

"I'm dying, and I know it," she'd told me two months earlier.

She had said this as we nibbled on salads in a chain restaurant. My fork stopped in midair, all appetite gone. I couldn't dismiss her comment as just the fear of someone tired of being a patient. She was a hospice home care worker. She knew things , as she always put it, and her insistence scared me.

"The doctor said he knows people who've lived with this disease for years," I said, shaking my head. "He's never said you were dying."

"He doesn't know what I know," she said, softly but firmly. "It's my body, and I know what it's telling me. I know what dying feels like."

A few short weeks later, the doctor who had assured her that she had plenty of time turned a tortured face toward me as I stepped outside her hospital room.

"How did she know?" he said. "I'm sorry I was so wrong. I want to know how I missed this. And how did she know?"

I was taken aback by his honesty and grateful for the irrefutable signs of his regret. Whatever anger I felt about his miscalculation melted in the time it took me to recognize him as a fellow human being. His magic had failed, but not from want of trying.

The New York Times reported last week that a number of academic medical centers are encouraging health care providers, including doctors, to disclose medical errors to patients and offer sincere apologies and fair compensation. What a dramatic and welcome departure from the typical defend-and-deny practices of most hospitals.

There may be a financial incentive here.

Some research suggests that when hospitals offer full disclosure and earnest regret, they suffer fewer lawsuits for malpractice.

Creating an environment where mistakes are admitted openly and explored also allows hospitals to learn from their errors. To encourage this practice, 29 states have made such apologies inadmissible in court as evidence of wrongdoing.

Dr. Daniel Ornt, who oversees curriculum development at Case Western Reserve University's medical school in Cleveland, says it's premature to claim that apologies curb lawsuits. He does, however, see other good reasons to embrace the practice.

"We're doing a lot of things to emphasize better communication with patients, including those times when you have to deliver bad news, even when the bad news isn't your fault," he said. "Apologizing for mistakes may reduce the anger and litigation, but it's also just the right thing to do."

Sometimes the apology helps the doctor as much as the patient. Last year, Boston doctor Rick van Pelt described for CBS News his guilt over accidentally giving a nearly lethal dose of anesthesia to a patient. The hospital told him to admit nothing, and the patient was told she'd had an allergic reaction. Over time, though, van Pelt could not accept his complicity in the lie. He wrote a letter to the patient to explain what really happened and to apologize. Two years later, they met in person, which was the final step in recovery — for the doctor.

"For me, the biggest piece of this conversation was her offering me forgiveness, you know," van Pelt said. "And it still sends a chill down my spine. Forgiveness goes both ways. It helps both sides."

Nine years ago, no one ever blamed my mother's doctor for her death from a disease that ravaged her nonsmoker's lungs. But the memory of his apology and his earnest attempt to learn from what had happened still comforts me.

There are times when "sorry" is the only thing to say.

And sometimes, a doctor's apology helps everyone to heal.

Connie Schultz is a Pulitzer Prize-winning columnist for The Plain Dealer in Cleveland and the author of two books from Random House: "Life Happens" and "… and His Lovely Wife." To find out more about Connie Schultz (cschultz@plaind.com) and read her past columns, please visit the Creators Syndicate Web page at www.creators.com.

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