Immortal Bird at NYU Medical Center or/ A Tale of Two Hospitals
–I have not posted for over a month but I continue to give talks about Immortal Bird and the issues it raises, particularly regarding medical errors and ways to improve medical care. And the medical establishment, to my surprise, continues to discuss Immortal Bird and the lessons it holds for patient care and communication. But this week, for the first time since Damon died in 2005, I felt our story was being heard by the medical profession in a new way, and I even received an apology for all the things that went wrong with Damon’s care.
–The apology, albeit eight years late, was sincere and heart felt. The hospital, its head and its leading physicians said they were deeply sorry for all the mistakes and mistreatment recounted in Immortal Bird and no one should have to go through what Damon and our family went through. It was a deeply moving experience, balm for a still-festering wound.
–Alas, the apology did not come from New York Presbyterian/Columbia University Medical Center–the hospital where Damon died!
–Columbia University Hospital, charged by our family in a still-pending lawsuit with carelessness, negligence and malpractice in Damon’s death, persists in claiming to have “lost” all Damon’s relevant medical records and to deny accountability for his death. Instead, the apology about how the health care system failed Damon came from New York University Langone Medical Center, a facility not involved with his care, and therein lies a tale of two hospitals and two different philosophies of care and how to confront, and learn, from one’s mistakes.
–NYU Langone has a dynamic Dean and CEO, Robert Grossman, a neuroradiologist by training, who has made quality care his number one priority. Grossman has instituted many innovative, data-driven methods for monitoring performance and outcomes by individual physicians in every department and he also holds weekly lectures and discussion series for his top medical faculty and staff to share what is right, and what is wrong, with current practice. Grossman believes in relentless self-assessment and self-improvement, and his aggressive efforts were recently rewarded when NYU Langone was ranked number one for overall patient safety and quality among leading academic medical centers across the nation.
–Grossman received a copy of Immortal Bird from a colleague and became so enmeshed in the story, he read it in two days. He then purchased 40 copies and made it assigned reading for the Wednesday lunchtime discussion series. He invited me to address his team and asked the bioethicist Arthur Caplan to moderate the discussion. The talk was not open to the public or the press.
–This Wednesday November 7, I was the guest speaker at a private luncheon of about 50-60 department chairs, head physicians and medical administrators at NYU Langone Medical Center. I spoke about Damon and about our experience in negotiating the health care system as we tried to save his life, and I included both the highs and the lows of our encounters with the medical system. I pinpointed continuity of care, direct observation of the patient and the difficulty of getting good comparative outcome data. The goal of this meeting was to learn from the mistakes made in our case in order to prevent them from recurring and to discuss ways of improving patient care in light of our experience.
–While I expected a certain defensiveness and professional “guild” solidarity as I faced 50 top doctors and told them what had gone wrong with my son’s care, I was surprised by how emotionally open and available this group appeared to be to Damon’s story. They had read Immortal Bird and listened to me as parents and family members first, physicians second. One senior doctor quoted passages I’d written back to me as only a fellow father could. Most of the people in the room seemed to understand and identify with my frustrations, pain, anger, and tragic sense of loss.
–I was equally impressed by the assembled medical professionals’ desire to learn from our tragedy and use it as a guidepost to institute a better and more responsive system of care. One physician asked me whether, given all my experience with such a wide range of doctors–from very good to very bad–I could suggest the best criteria for selecting medical students. What qualities should the admissions office be looking for in the doctors of tomorrow? It was an excellent question and cut to the heart of the issue, and it was asked in a spirit of genuine inquiry and desire for the right answer. I am not a medical expert and I had never thought about the question in this way, but my instinctive reply was that assuming a baseline of academic competence–courses, grades, MCATs etc.–the human element was paramount. They should be looking for top human beings, young men and women who were going into medicine because they cared about others and wanted to help them get the best treatment possible and who scored highest on the capacity for empathy, compassion and selflessness.
–We discussed other important issues such as who else in the treatment team beyond the physician could improve the patient experience and how to deal with the long-term fall-out, including grief and mental health challenges. There were experts in the room in each of these areas, and it was clear everyone understood there were deficiencies that needed to be addressed and improvements that needed to be made.
–“Quality defines individuals, and institutions,” Dr. Grossman wrote me after, “and without it there is no trust, no relationship and no responsibility–the core of medical CARING.” Let us hope that the NYU Langone Dean and CEO wins the day and that his humane, rigorous, patient-centered approach to running a hospital and ensuring the highest quality of care and safety for all becomes the standard of care in every medical center in America so that tragedies like Damon’s can be prevented in the future.