Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Postoperative Care And “The Black Swan”

This is a guest post by J. Paul Curry, M.D.

I was inspired when I lost my best friend 15 years ago to a common medical-error phenomenon: The lack of monitoring patients in the hospital.

Losing Mark altered my entire career in medicine and started me on a long journey of trying to understand how this particular problem happens. The journey has been eye-opening for me for many reasons, and probably most importantly by striving to learn and understand how the human brain can deceive itself into believing that thoughtful, rational, goal-directed tactics are always the solution to finding the answers to highly-complex enigmas.

Actually, the blockbusting solutions that change the course of our culture — how we do things — are most often totally unpredictable and discovered by accident by disruptive innovators, such as Dr. Larry Lynn of the Sleep and Breathing Research Institute, willing to tinker on their own and against the grain of thousands of smart people who dismiss this kind of outlier work as fantasy. To get just how often this happens and why, I’d invite those unfamiliar with Nassim Nicholas Taleb’s work to read “The Black Swan : The Impact of the Highly Improbable” and other books of his. This is what we’re up against today.

I was recently operated on, having a significant multi-level back surgery at one of the outstanding university spine programs in the country, supported by one of the elite anesthesia programs. I was told by the resident that I’d be going to the general care floor following my surgery, where I’d be checked on regularly. This was a given because I’m a fitness fanatic, but the resident wasn’t prepared for my followup questions. As I probed for more detail, it became apparent that no one in the organization had any inkling that nursing checks only occurring every four or eight hours on a patient fresh from surgery with patient-controlled narcotics was less than standard of care.

I told them I have mild sleep apnea and wanted pulse oximetry at minimum. I had to be upgraded to telemetry to get it. What’s more interesting is that there was so little understanding of this problem that they put me on pulse oximetry in a room where the only one who could watch it was me — the patient. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »

Commented - Most Popular Articles