Wrong

Teachers are supposed to prepare lectures with meticulous attention to details and rules. Students should be told right from wrong. Well, that's the theory, anyway. Teaching medicine is a different story. It's not that simple. Although we can find protocols and guidelines (and even treat them as the Ten Commandments chiseled in sapphire), many of them don't work in real life.

Impractical rules aside, doctors are more often wrong than right. Well, surprise, surprise. In the lecture hall (or examination hall), our own sense of rightness runs deep, and our students' faith in our rightness is as fixed as the delusion of schizophrenic patients. In short, doctors can be wrong when we think we're right. That's the first lesson I told my summer students who saw patients with me this month.

Why should the students, then, follow me who can't even tell right from wrong? In a sense, that's the blind following the blind. Quite true. Still, it's somewhat better than being blind without realizing one's blindness. My lesson for them is about being wrong: about how doctors can be wrong, and how we cope when we're wrong.

Full disclosure: I just made a mistake after I demonstrated to my students how I diagnosed pericardial effusion in a patient with breast cancer last week. Oh, that's a serious condition when a big sac of fluid encases the heart. As the sac of fluid fills, it hugs the heart harder and harder, like a boa constrictor. The result can be calamitous because the heart can't beat - you can only save your patient's life by sticking a needle and then a catheter to drain out the fluid. I was glad my students were around to see how I did that maneuver.

And everything seemed to be going great until next morning, when I found out that my catheter had been pushed in far too deep.

I'd punctured my patient's heart wall. My heart sank, and so did my patient's.