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The dangers within healthcare

When I go to the hospital or to the doctor’s office, I expect several things. First, I expect to be treated with kindness. If my problem was self-imposed (e.g. obesity), I expect the healthcare provider(s) taking care of me to not point to me and laugh or blame me for my problem, even if it is my fault. I expect them to nod and be agreeable, especially when I’m already feeling crappy. Second, I expect them to act in my best interest. They are supposed to do whatever needs to get done to ease my pain and heal me, at whatever cost. Finally, I want them to use the best science, evidence, and available knowledge in taking care of me. If something has been proven to work better than something else, and that something is readily available, then I expect them to use it.

Of course, healthcare providers at all levels are people, humans beings. They’re fallible. They can and will make mistakes. So I’m not surprised when people throw around statistics blaming errors in healthcare as a top reason for death in the United States. I’m not surprised because hospitalized people are, by definition, in a weakened state. Under those circumstances, even a small error can mean certain death for them. (I’ll leave the discussion on the exaggeration of these statistics, e.g. “allopathic medicine is killing you, try my homeopathy,” for some other post at a later time.)

The other thing about humans is that a subset of us will “snap” and do something that can only come out of a nightmare. Thankfully, it’s a very, very small subset. But it is not beyond reason to say that there are people in healthcare right now, at all levels, who are psychopaths.

When I was studying for my MPH, I wrote a paper on one such person. His name is Michael Swango, or “Double O Swango” to his friends. Mr. Swango went to medical school. While there, he worked as an ambulance worker, so much so that his studies suffered. He barely got through medical school and was allowed to pursue a career in medicine. The suspicion is that Mr. Swango killed people as early as the time when he worked the ambulances while in med school. He would then go on to a series of jobs as a paramedic and as a physician, all the while, it is believed he killed people. He even went to Zimbabwe, where the suspicions continued. Mr. Swango was finally aprehended and convicted of several murders, but many deaths that happened around him, while he was working, remain unexplained and are possibly associated with him, if not outright caused by him. My paper was a study on the many opportunities to stop him that were missed because of all sorts of reasons.

More recently and closer to home, a radiographic technician has been arrested and charged with misuse of narcotics intended for patients and, worse yet, infecting said patients with Hepatitis C. He worked some of that time in Maryland, and he is believed to have infected some patients there. Because of this, the health department compiled a report on what happened, how it happened, and what recommendations should be followed to keep it from happening. It’s really quite a read, and I found myself continuously shaking my head as I read it. Like with Swango, it appears that there were plenty of opportunities to stop this guy, but they were missed. Go read it (PDF). It’s really something.

On the one hand, I understand that people will make mistakes and things will be overseen by accident. A provider may prescribe something that is not recommended or even dangerous for a patient because of an allergy. It happens. As long as it doesn’t happen continuously, or continuously after remediation has been done, I’m okay with that. I’m willing to accept that medical errors kill people because it’s one of those realities in life that we must seek to minimize but will never eliminate. On the other hand, it fightens me to think that things like “professional courtesy” or, as was the case with the radiographic technician, fear of litigation may allow a killer to walk the halls of a hospital or come to my aid during an emergency.

You see, threats to public health are not just within us and around us in the form of disease and disasters. They are also around us in the form of fallible people. Worse yet, they are around us in the form of criminals who manage to become healthcare workers.

One more thing on my “to-do” list in my career, I guess.

Categories: Blog

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René F. Najera, DrPH

I'm a Doctor of Public Health, having studied at the Johns Hopkins University Bloomberg School of Public Health.
All opinions are my own and in no way represent anyone else or any of the organizations for which I work.
About History of Vaccines: I am the editor of the History of Vaccines site, a project of the College of Physicians of Philadelphia. Please read the About page on the site for more information.
About Epidemiological: I am the sole contributor to Epidemiological, my personal blog to discuss all sorts of issues. It also has an About page you should check out.

6 replies

  1. Very interesting, especially since my husband underwent a number of cardiac interventional procedures.

    I, of course, enjoyed reading the reports detailing the crimes committed by the doctor and the radiology tech, because I’m an avid reader of true crime books.

    I recall, when I worked as a public health nurse an extended investigation of acute hepatitis C cases that were traced back to a pain doctor’s injections. As soon as the likely source was identified, the doctor was notified and a doctor and a nurse were sent to observe his “technique”. Turns out he was double dipping into a vial of injectable pain medication and didn’t “waste” the remaining medication…too cheap, I suppose. Wouldn’t you think that a doctor who specializes in pain treatment and who actually injects pain medication into most of his patients, would know not to double dip and then save the remaining medication in the vial, to use on another patient?


    1. You would think a lot of things were common sense for trained medical professionals, but it’s been my experience that they’re just like the rest of us, prone to be sloppy. If I could write a book on the things I’ve seen as a lab tech, it would be a very long book.


    1. I like Dr. Jay. I really do. He’s a good person, and he means well. I haven’t heard of him being evil towards people he disagrees with. He certainly was very patient with me when I used him as the subject of just about every posting on the old Epi Night School.

      That said, I’m really bothered by the way he keeps on harping on the same things that a whole bunch of us (some of us experts) have tried to explain to him. I mean, “prevent autism”? Really?

      Sigh. I’ll be over later. Not tonight. It’s been a long day.


  2. Maybe I’m late to the party, but I have to say:

    Thanks for being back where I can read you!


    1. I’ve had this blog for a while. I only started broadcasting it when I knew I was going to Hopkins. Good to know you’re reading!


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