Bmj Usa: Minerva


BMJ 2003; 327 doi: (Published 19 November 2003) Cite this as: BMJ 2003;327:E46

This article originally appeared in BMJ USA

The Washington Post carried two articles on the medical establishment's Dickensian attitude to fatigue among doctors and its impact on medical error (March 23, 27), prompting a spate of letters to the editor (April 10). Doctors' leaders are self deluded about the problem, the articles say, and none more so than one Harvard trained surgeon who claimed: “Surgeons are built differently [to other people] and become impervious to exhaustion.” His own frightening schedule included meeting his trainees every Sunday morning at 8:30 am to listen to their grievances. He dismissed complaints about fatigue as “whining.” (See the editorial on fatigue in this issue of BMJ USA on p 294.)

When the medical authorities in Indiana issued police officers with automatic external defribrillators, they hoped survival would improve for people having cardiac arrests out of hospital. It didn't. A before and after study showed that if the police arrived before the paramedics, they carried out defibrillations flawlessly. Unfortunately they arrived first in only 6.7% of cases (Academic Emergency Medicine 2001;8:324–330). The rest of the time, the police were too busy or too far away to make it in time. …

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