Internal Bleeding

When we first came to UCSF, we were all given the book Internal Bleeding by Robert Wachter (chief of medicine, shown above) and Kaveh Shojania. Although I read it as a first year, upon rereading it recently, I've found it to really resound with my experiences in the hospital. The book discusses medical errors in the hospital setting from all perspectives. It takes the reader through a comprehensive and compelling story of medical mistakes, discussing how things as absurd as wrong-site-surgery or treating the wrong patient actually happen. The book draws the often-cited comparison of medicine and aviation. It brushes on topics like doctors' handwriting, medication errors, teaching hospitals, long work hours, patient handoffs, and problems with teamwork. Each chapter begins with a real patient case and the root cause analysis in each chapter is convincing. Not only that, Drs. Wachter and Shojania go further to propose solutions to this epidemic problem. They take a systems approach, looking at reporting of mistakes, how to tell patients what happened, medical malpractice, and accountability. I think this is the crux of the book; while all practitioners are aware of the problems in medicine, few solutions are proposed. For those interested in hospital management, systems-based practice, patient safety, and health care policy, this is a must-read.

Images shown under Free Use, from biblio.com and ucsf.edu.