Heroes Not Zombies

You maybe read the story about the Scottish nurse who came back to the UK after nursing Ebola patients in Sierra Leone?

Because she had travelled from West Africa she was “screened” at Heathrow – they checked her temperature. It was normal. She told them she felt fevered and unwell but they said her temperature was normal. She returned to the screening area an hour later because she was concerned that she was unwell and had her temperature checked “by officials” (did they have any medical training?) a further six times, but each time the thermometer said she didn’t have a fever so they sent her on her way to Scotland. She’s now (at time of writing) being treated in hospital for Ebola.

What amazes me, yet sadly doesn’t really surprise me, about this story is – imagine this – a nurse comes to see you, tells you she has just returned from West Africa where she has been nursing patients with Ebola and now she feels unwell. What would you do? Right. You’d listen to her story, hear what she was experiencing (feeling unwell), and hear what she’d been doing recently (travelling in West Africa and treating patients with infections in a hospital). Would you be happy to rely on the reading from a single piece of equipment (a thermometer) to determine what you should do next?

Nope, I wouldn’t.

Who would?

Only someone who had designed a “process” (probably described in a manual somewhere) which said check the temperature. A process that basically says something like if the temperature is normal, OK, say “on you go”. If not normal, do something (I don’t know exactly what the officials are told to do if the thermometer tells them there is a problem….we didn’t get that far in this case)

I was once told by a young doctor they were taught “Don’t listen to the patient, they lie all the time. Only the results tell the truth”

You know what? That wasn’t good teaching then, and it isn’t now.

When it comes to the practice of Medicine, you ignore the patient’s story at your peril.

And the same rule applies when designing a health care system.

Health and illness are experiences people have, not readings on equipment.