Patrick Malone - The Life You Save: Nine Steps to Finding the Best Medical Care-and Avoiding the Worst

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Patrick Malone has written a book that really could save a life. With his moving real life stories and his brilliant advice this book is a must-read for anyone who cares about their health and well-being.

SORREL KING, THE JOSIE KING FOUNDATION

This highly practical book guides you through the essential steps for maintaining your health and avoiding medical mistakes. An invaluable resource!

JOAN CLAYBROOK, FORMER PRESIDENT OF PUBLIC CITIZEN

Patrick Malone has what Pete Conrad would call The Right Stuff. We owe him a debt of gratitude for focusing a beam of light on saving lives.

NANCY CONRAD, FOUNDER AND CHAIRMAN OF THE CONRAD FOUNDATION

Patrick Malone has compiled a remarkably well-researched set of you-cannot-afford-not-to steps to take, aided by a series of life-saving checklists of questions patients need to ask, that can make the difference between getting excellent medical care or becoming a victim of impaired health, or even death, from much worse care. Doctors and other health professionals make mistakes too often to justify a false sense of security. This important book teaches patients and their families how to catch them before they cause injury or death.

SIDNEY WOLFE, MD; EDITOR, WORSTPILLS.ORG; DIRECTOR, HEALTH RESEARCH GROUP AT PUBLIC CITIZEN

To my wife, Vicki, who keeps me healthy

Note: The information in this book is true and complete to the best of our knowledge. This book is intended only as an informative guide for those wishing to know more about health issues. In no way is this book intended to replace, countermand, or conflict with the advice given to you by your own physician. The ultimate decision concerning care should be made between you and your doctor. We strongly recommend you follow his or her advice. Information in this book is general and is offered with no guarantees on the part of the author or Da Capo Press. The author and publisher disclaim all liability in connection with the use of this book. Some names and identifying details of people associated with events described in this book have been changed. Any similarity to actual persons is coincidental.

THIS BOOK COULD SAVE YOUR LIFE

The sound patients make when they fall off the earth is so quiet that hardly anyone can hear it. For one of my clients, Richard Semsker, a forty-six-year-old attorney, the sound was a thin rustle, as his internist handed him a sheet of paper that told him his life was ruined for no good reason. He already knew that the mole on his lower back, which had recently turned a mottled blue-brown, had proven to be an aggressive cancer, a melanoma. But now the newly discovered paper told him that a dermatologist had recommended the mole be excised eight years before, long before it turned deadly. Somehow, no one had notified the patient. Richard stared at the eight-year-old letter, which his internist had resurrected from the thick jumble of papers documenting twenty years of routine internal-medicine treatment: for headaches, high cholesterol, poison ivy, and the painful boils on his back that had led to several referrals to the dermatologist. Inside, Richard was screaming. Outside, all was hushed. It would be impolite to make any noise.

So it goes with many hundreds of thousands, even millions, of Americans each year. When a person learns that a preventable medical mistake has stolen his health and that it is too late to do anything, the shock of being twice victimizedfirst by a curable disease and then by the caregivers who were supposed to helpcauses a dizzy feeling, like everything securing him to the earth has let go. Caregivers turn from allies to adversaries.

Could this happen to you? The odds are unsettling: Medical catastrophes have been documented to so pervade the American healthcare system that a realistic risk of needless death or serious injury confronts every family in the United States at some point. But theres good news too: You can do a lot to protect yourself and to secure for you and your loved ones the best that our fragmented, expensive system has to offer.

This book gives voice to victims of bad and mediocre health care and to patients who have successfully navigated the American healthcare system. You will see how tragedies could have been averted. And you will watch as the successful patientsmany of whom were victims firstenlist doctors and nurses to help them care for themselves. They clear up miscommunications before harm occurs. They persist in looking for cures when doomsayers have told them to give up. They refuse to accept Its all in your head and learn how to unlock the puzzles of their bodies strange signals. They politely decline to have their bodies cut open by mediocre surgeons and negotiate access for themselves to the best surgeons and hospitals. They become literate in the statistics of their diseases and figure out how to use numbers to make wise decisions. In the process, they learn that the best way to win the longest, healthiest lives for themselves is to take charge of their own health care and not merely turn their bodies over to an impersonal and broken medical industry. The life you save, as the novelist Flannery OConnor once wrote, may be your own.

To learn how to work the system, you need guidance from an expert in the system. And thats where I come in. Over the last twenty-five years, I have represented hundreds of patients and their families who lost their health to the health-care system. In each case, Ive done a legal autopsy to figure out what went wrong with the patients health care and why he or she was injured or killed. Before I became a lawyer, I spent a decade as a journalist covering both the best and the worst of the American medical system. In both careers, Ive learned how to find the best medical care and avoid the worst. Ive learned that you dont have to have a degree in medicine to understand enough to make smart medical choices. Ive learned that you do need common sense, curiosity, and persistence. And you need a plan. And thats what I have put together in these pages.

Americans spend more on their medical care than people anywhere in the world, by a long shot. A large chunk of that extra expense is leached out to feed the paper shufflers in the health-insurance bureaucracy, who add no real benefit. But some of the money gives us amazing technology that lets doctors peer into the deepest recesses of our bodies without cutting and perform treatments on the cellular level that would have been unthinkable only a few years ago.

Yet critics routinely describe this same health-care system as broken. Frightening statistics abound: Every year, some 100,000 people die and hundreds of thousands more are injured unnecessarily. Medical mistakes claim more lives each year than breast cancer, AIDS, and motor-vehicle crashes combined. Apollo astronaut Pete Conrad rocketed to the moon and back safely in 1969 but died of poor emergency-room care thirty years later. Medication errors alone kill more people each year than die in all the workplace accidents across the country. Its like a jumbo jet crashing every day. Arresting statistics, yes? And all of them came from a 1999 report from the Institute of Medicine, part of the National Academies of Science. The authors worked hard to dress up their otherwise wonkish report with sexy, alarming numbers, and across the country the report sparked pilot projects dedicated to saving lives and reducing errors. Just the name of one project will give you an idea of the scope of the problemthe 5 Million Lives campaign of the Institute for Healthcare Improvement projected that American hospitals could save 5 million patients from harm over two years by implementing just twelve specific strategies. Five million! The same institute estimates that 40,000 incidents of medical harm happen every day in the United States. These episodes can and do happen anywhere. Anyone who thinks it cannot happen to me because my doctor went to a brand-name medical school and works at a prestigious hospital is badly mistaken.