Pat Mastors, a patient safety advocate, has written a clever blog post called, “A Few More Minutes with Andy Rooney.” Channeling the curmudgeonly tones of a 60 Minutes commentary, it begins:
I died last week, just a month after I said goodbye to you all from this very desk. I had a long and happy life – well, as happy as a cranky old guy could ever be. 92. Not bad. And gotta say, seeing my Margie, and Walter, and all my old friends again is great.
But then I read what killed me: “serious complications following minor surgery.”
Now what the heck is that?
The blog goes on to have Rooney ask for someone to find out what actually killed him. This has offended some respondents who, blinded by their own biases, think a writer using a celebrity’s death to push for information that could be used to improve care is the same thing as accusing his physicians of negligence or hauling Rooney’s family into court to publicly disclose private details.
Don’t you hate people like that?
OK, that was a cheap Andy Rooney imitation. But as it happens, I did have a phone conversation with Rooney about patient safety. It came right after the Institute of Medicine released its landmark report, To Err is Human, in November, 1999. The appalling toll of medical errors wasn’t exactly a secret back then, but doctors and hospitals had gotten used to publicly tut-tutting about the “price we pay” for medical progress every time a new study came out and then going back to doing exactly what they’d been doing before.
But this time was different. First, the IOM used names of real victims, taken from news reports. That meant real families who could appear on TV or testify before Congress to give the raw numbers a human face. Second, those numbers were raw, indeed: 44,000-98,000 preventable deaths each year in hospitals alone. Maybe not news to JAMA readers, but a jolt to the general public. Third, the group making this claim wasn’t some nattering nabob of Naderite negativism, but a prestigious part of the National Academy of Sciences. This was the “House of Medicine” demanding a housecleaning.
Oh – and as CBS News health and medical correspondent Dr. Emily Senay told me when she called, it was also a slow news week.
My book, Demanding Medical Excellence: Doctors and Accountability in the Information Age, had come out two years before. I had been deeply shaken by what I discovered when examining the frequency and severity of medical errors. I wrote:
The frightening reality is that medical mistakes of all types are not unusual. Treatment-related injuries kill anywhere from two thousand to three thousand people every week, according to two major scientific studies – and that’s just in the hospital….
So why don’t doctors and other caregivers pay more attention to errors? Before caregivers will act decisively, they – and the public – need to give up once and for all the comforting belief that the danger posed by treatment-caused errors is either unavoidable or hardly exists at all.
Senay and I chatted for awhile, then she asked if I would mind talking to Andy Rooney. Of course, I jumped at the opportunity. The famous voice on the other end, clearly intrigued by the IOM report, asked me a few questions about medical errors. I offered to send him an autographed copy of my book. He reluctantly agreed to send me an autographed copy of his (latest) book. What exactly did he ask? To quote the title of the latest book by Nora Ephron (someone I have neither met nor spoken with), I Remember Nothing.
To my knowledge, Rooney never did a commentary on the IOM report. Those who watched the 60 Minutes farewell interview with Rooney when he retired know of his strong aversion to signing autographs. That probably explains this odd inscription:“To Michael Millenson, from his friend Emily Senay and mine, Andy Rooney.”
Rooney’s family may have excellent reasons to be vague about the cause of his death – “serious complications” can refer to some gruesome conditions the family would rather not have become part of the public’s image of their loved one. That being said, I became a journalist at a time when Rooney’s generation was at the peak of its influence. They were tough reporters – our brief conversation was no-nonsense – and there’s no doubt in my mind that he would delight at a commentary that poked and prodded doctors and hospitals about the cult of secrecy that keeps on killing patients more than a decade after the IOM’s blockbuster report.
A year ago, in fact, I wrote a piece about the snail’s pace of progress for the Health Affairs blog entitled, “Why We Still Kill Patients – Invisibility, Inertia and Income.” Like my book, it’s amply footnoted and anchored in the medical literature. I’m no longer a journalist, but when it comes to patient safety, I would be proud to be labeled, like Rooney, a curmudgeon.
Michael Millenson is a Highland Park, IL-based consultant, a visiting scholar at the Kellogg School of Management and the author of “Demanding Medical Excellence: Doctors and Accountability in the Information Age.”
I’m grateful to Michael and other supportive voices within the medical industry who see value in the Rooney piece, and to all who engaged in a thoughtful debate, including those who rightly point out a concern for Rooney’s family. (As for those who post anonymously, how does that advance the dialogue?)
As a journalist for more than 20 years, it was my job to separate my personal opinion from what I publicly reported. It was certainly a safe and comfortable refuge from critics. However once medical harm strikes your family, that comfy place can increasingly feel constricting and false.
We need more talking points and strategies that unite patients and providers in shared realities and common goals – that jolt us out of the “echo chambers” where many provider groups and patient advocate groups currently function. I borrowed Rooney’s voice because I felt as the voice of “every man”, his was one all stakeholders might listen to.
Many didn’t get Jonathan Swift’s “A Modest Proposal” either. I loved your piece. I’m grateful for your work. If there ever is a need for independant voices on the net to speak sense to your critics, could someone point me to the criticism so I can be one of those who talk back to it?
So these 2 posts are basically, at least just a little bit … a joke? Or maybe a NOT joke? (to speak with the words of my journalistic celebrity friend Borat Sagdiyev, truly very influential for his generation)
Sorry for having been such a sourpuss initially finding the idea neither clever nor funny.
And thanks from me, too.
The subject is serious, literally a matter of life and death. But Rooney of all people knew what a dreary place the world would be if everybody got all long-faced every time a serious subject came up.
Great post Michael, and from one former journalist to another, you nailed it. Keep up the scholarly work. Patient safety first and always!