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Book Review: Internal Bleeding

Darell Schmick
Information Services Librarian
University of Missouri-Columbia
SchmickD@health.missouri.edu

I had a chance to read Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes. Penned by two physicians, the authors do a great job explaining the shortfalls present in the healthcare field, the errors that can arise from such shortfalls, and what actions the reader/patient can take to be better protected from medical errors.Internal Bleeding book cover In each chapter, the authors discuss issues of particular interest and value to the vigilant patient. The final chapters (which advise the reader of what he/she can do to protect themselves from medical errors) are worth the read alone. Small things, such as “bring a list of medications you’re currently taking when going to see the physician” are simple but important takeaways that can reduce the chances of error when entering as a patient in the healthcare system.

The book is filled with stories that will grab your attention, and are likely to make you uneasy at times. After each vignette, the authors take a step back and explore what happened. What went wrong, and at what point? What could have been done to prevent it? It’s akin to a morbidity and mortality conference, candidly conveyed and crisply condensed for a general audience.

In one stirring example, a Mexican teenage girl whose life depended on a new heart and lung transplant sought care from a world class medical center in the United States. The specialists that her family was fortunate enough to find were top tier and confident that they would be able to save the child’s life, provided a perfect match could be located. After several untenable prospects, a “perfect” donor match was finally located halfway across the nation. This was incredible, considering the impossible requirements: the heart and lungs must be from a newly deceased adolescent boy or girl, and must be completely intact. The organs from this miracle donor were successfully excised and shipped in ice, ready for transplantation. The parameters and requirements for transplantation were all fulfilled, save one—the blood types of the patient and donor were not compatible. The surgery continued, with all parties fully aware of the new set of complications arising from a patient rejecting her newly implanted, incompatible heart and lungs.

The authors refrain from chastising the actors involved, but rather use this as a lesson in how miscommunication can derail what should have been an otherwise successful operation.

There is no perfect system, and the authors illustrate that the healthcare industry is no exception. While it is impressive that our healthcare system runs as well as it does, errors arise from time to time. And when that happens, the authors point out that money is wasted, careers are ruined, and lives are lost.

Not only is this an important read for patients and doctors, but for the librarians who serve them as well. For me, it really hit home hard that the lack of specific information at the right time can have deep and lasting implications. I highly recommend reading this book to anyone with an interest in patient safety.

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