“The pleasure of taking risks” by Dr Daniel Rodezno


The pleasure of taking risks

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How many times in your life have you regretted things that you have not done?

Lack of time (perfect excuse among physicians), monotony and our fear of giving up our comfort zone often deprive us of living great experiences that can change our lives positively.

Making such an important decision like moving to another country for a few months can seem a little intimidating and much food for thought.

In my case, it was due to a mixture of objectives: To know other cultures, improve my English, to network and grow professionally by observing how things work in other hospitals, which led me to decide to request an external rotation to the UK.

My name is Daniel Rodezno, and I am fourth-year resident of Urology in Hospital Son Espases and I’m currently making an external rotation of two months in the UCLH (University College London Hospitals) and I wanted to share some of my experiences and impressions with you.

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After months of intense paperwork, permits, and economic and academic decisions were very pushy, I moved to England in January 2015.

After realizing in my own skin that I had chosen the coldest months to visit the country, I moved to an area near the center of this magnificent city, London and the hospital where I am rotating into a small and comfortable room; which can mean that you can save a few Euros in transport considering this is one of the most expensive cities in the world.

The cold, gray morning mist added a mysterious touch to this noisy city where the blend of luxury and cultural diversity make London one of the most unique and interesting cities in the world.

Only a few kilometers away are the facilities of the Hospital; one of the newest and most modern in the UK and Europe, which serves as a reference center around the UK.

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My rotation is with the urethral reconstructive urology department led by the renowned Prof. Anthony Mundy and his team. A mature, elegant and serious, but kind man; who in each surgery shows a skill worthy of his fame accompanied by a professorship at each step of the process, aimed at other students like me who come from around the world to observe and learn.

Every small and great detail in the operations that are different from those we already know with explanations will enrich and change your perspective a little bit more; Not to mention having to deal with an exquisite English accent, which is a bit difficult to get used to at the beginning; but in time, you adapt and begin to enjoy it.

After a hard day’s work, along with other colleagues I am taking the time to get out and enjoy this beautiful city and its people, with its parks, monuments, gastronomic and cultural diversity that perfectly complement the experience.

I still have a few weeks here until I go back and return to the routine of the comfortable, familiar and safe…

It has definitely been one of the best experiences of my life, and I hope this short review will motivate others to make an external rotation as part of your training which happens in the blink of an eye; more important than this, encourages you to take a risk.

“When you want something you should know that you must take risks and that’s what makes life worth it.”

Paulo Coelho.

Doctors make mistakes: A few comments


” Anyone who has never made a mistake has never made anything new” So I am going to start this new post with a quotation by Albert Einstein. Well, I do not think that is a bad way to start, and I always thought that if you want a quote about anything then all you need to do is to look up the Albert Einstein compendium and you will be able to find something perfect to fit your topic.

And today’s topic is “mistakes”

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Everyone makes mistakes. It is part of human nature. When you are at school you make mistakes and you go home terribly abashed to have to tell you mother and father that the exam was terrible, and you made a lot of silly mistakes. Some parents will get angry and punish the child, but the cleverer parent will sit down, chat to the son or daughter and explain that mistakes are normal, nobody is perfect and the key is to learn from those mistakes. The critical thing is, of course, to accept the mistake and then learn from it and try not to make the same mistake again.

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And hopefully not like Samuel Beckett!

Today I wish to talk about a new article published in the Guardian newspaper by Lord Ara Darzi, the English surgeon working in Imperial College London. His article is entitled ” Doctors make mistakes. The best thing medicine is for them to admit it”, and I think that it is interesting because it seems so obvious. Even though in the past doctors were seen to be removed, or in some way “above” the normal man in the street, they are humans. The doctor is not God, the doctor has human foibles, and the doctor makes mistakes.

However, the critical thing is acceptance of the mistake, and then to act on that mistake. In the article Darzi mentions the American surgeon and writer Atul Gawande.

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Gawande is an American surgeon who worked as adviser to Clinton during the Clinton presidency, and who is this year’s Reith lecturer. You can listen to his first Reith Lecture on BBC Radio 4, ” Why doctors fail”, and in this fascinating talk he explains how his young baby son nearly died at the age of 11 days due to a medical mistake. He believes that transparency is the answer to trying to stop or stem the tide of serious medical mistakes. He says –

” How are we going to make it possible for other children like Walker to live a normal life? Only by removing the veil over what happens in the clinic and hospital, only by making what has been invisible visible”. Walker is the name of his son, who having survived the nearly fatal mistake when a baby is a now a healthy teenager with a great and exciting life ahead of him. Darzi then goes on to comment on a new but long fought for initiative in the British NHS to open up the NHS and make it more transparent and more responsible to the people, to the potential patients. Last week the NHS published the individual death rates of 5,000 surgeons in ten different specialities throughout the UK; these data can now be seen on the webpage MY NHS: Data for better services – http://www.nhs.uk/Service-Search/performance/search 

I believe that this is an incredible step in the right direction, obviously one that is extremely difficult to put into practice and also interpret. What data do you use? What criteria? Can you really compare the work of different surgeons? The working circumstances are obviously different, no case is exactly the same.

All these things are true, but this is not the end of this move towards transparency but just the beginning and it is a fascinating and extremely brave decision. The idea was started and launched more than ten years ago by another surgeon, a cardiac surgeon, Bruce Keogh, and not by an administrator with no knowledge of the ins and outs of the operating theatre. Another doctor commented on by Lord Darzi was Professor Peter Pronovost, an anaesthetist working in the field of patient safety at Johns Hospkins Uinversity Hospital in Maryland. I have seen a talk of his given to first year residents about doctors making mistakes and it should be compulsory viewing for all trainee doctors and probably for all consultants. Doctors are humans, they make mistakes, this is normal. Remember this and act on it, and learn from it and remember you are part of a team.

Let’s see how this drive towards transparency continues, let’s see whether it could be possible to implant into different health care settings,and I am particularly thinking of the Spanish National Health Service. I end this short post with the ending of the article by Professor Darzi:

” Looking at our fallibility is uncomfortable, it makes people angry and has led to efforts at providing transparency being blocked. But as Ganawade says, it is the story of our time- and the key to the future of our medicine.”

Thanks, as always for listening, and have a great weekend.