My Greatest Mistake

No time to talk

BMJ 2004; 329 doi: (Published 16 December 2004) Cite this as: BMJ 2004;329:1496
  1. Kamran Abbasi, acting editor (kabbasi{at}
  1. 1 BMJ, London WC1H 9JR

    Think carefully enough and mistakes come flooding to mind—a missed pneumothorax, an unnecessary resuscitation, and a pacing wire that tickled a tricuspid—memories of follies that influence individual practice more than they ultimately affect patient outcomes.

    Yet, one memory still haunts me. I was a junior doctor in a busy specialty, rushing to manage patients and pass exams. My peers were coping with the same competing demands in their own firms and in their own ways. Some responded with machismo, their spirits unbowed; some by internalising their pain; and others with an equal calm.

    One colleague stood out. He was from overseas and a loner, but we struck up a friendship over pizzas, televised football, and black humour in the doctors' mess—the lifelines of a night on call. In six month posts these friendships ebb and flow, from endless hours in the mess on a quiet night to barely an acknowledgment when busy. And we got busier and we talked less.

    One day his firm had just swept through our ward, but he hung back, wanting to begin a conversation it seemed, a conversation I had no time for. I moved on, with a promise to talk later. The next day he wasn't at work. He was still in his room—directly across the corridor from mine—an insulin syringe lying next to his dead body. The next day, his mother flew in to reclaim her son. But how must he have suffered—alone, miserable, a long way from home, in an endless and thankless job, patients too ill to be grateful, colleagues too wrapped up in themselves to care.

    Would it have a made a difference if I had talked? My greatest mistake was not to find out. As the royal colleges strive for a new definition of medical professionalism, what will we do to ensure that professionalism extends to consideration for our colleagues?


    • Competing interests KA is acting editor of the BMJ and responsible for its content.

    • True confessions

      In October Minerva asked readers to submit their tales of clinical, career, or other mistakes, for publication in this issue. First to respond were Dave Sackett and Richard Smith, followed by others, some of whose confessions are printed below. You can see all the responses and add your own contribution on (

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