Safety Is Uncertain

Everything is actually

In late 2016 I had just passed all of the lab work required to obtain a new life insurance policy. My numbers were perfect and I was in great shape. I was less than a year past my unsatisfying attempt at competitive bodybuilding. And while I had given up on that dream, I hadn’t given up on the training and discipline of the craft.

On November 16th, I woke up early feeling queasy. It wasn’t terrible, but I wasn’t able to go back to sleep. So I went to work. By 9 AM my stomach was cramping so bad I knew something was wrong, so I told my boss I was heading to the doctor. On the way I called my wife and told her I thought I had a kidney stone (not that I know what that’s like, I still haven’t had one). She suggested that I go to an ER just in case I needed some kind of test a quick-care couldn’t offer.

The next 36 hours made me seriously question the cost of medical school

When I got to the ER, the triage nurse took my blood pressure and it was sky high. She set off all the alarms and immediately called in the doctor (by immediately, I mean an hour or so later). When he walked in I was curled into a ball trying to hold my insides in.

“Alright, Mr. Maldonado, lets get this prostate exam done,” he stretched a pair of exam gloves on as he completed that statement nonchalantly.

“What?” I rolled over and glared at him.

“Need to rule everything out,” he replied.

“Seriously? For stomach pain?” He didn’t flinch. “Are you joking?” He wasn’t…

This is a long story, so I’ll just hit the high notes

After that first unsuccessful “exam,” they hooked me up to an EKG (also not a freaking stomach test!). If you were in that room at the time, you would have thought the world was imploding. Apparently I was in what’s called Atrial Fibrillation (or AFib).

“We’re going to have to admit you, Mr. Maldonado,” my nurse explained. “If you’re in AFib longer than 24 hours, you’ll be at extreme risk for a stroke.”

I’ll skip the witty banter that occurred after that statement, but the long and short of it was that they could “shock” my heart back into normal rhythm. The only problem was that the ER (it was a standalone facility) didn’t have the equipment to do it.

So I got a super-fun $50k ride in an ambulance

When I arrived, the stomach cramps hadn’t subsided at all. The staff at the hospital hadn’t even gotten the message that I had come in for that. When I told my intake nurse, I was informed that they couldn’t give me anything for that pain because the cardiologist needed to evaluate my AFib first. As it turned out, I had a quite a while to ponder my situation and realized I had felt this way a handful of times before.

At 7 PM (almost twelve hours since I’d begun feeling off), I was finally visited by the first cardiologist. My wife and kids had arrived shortly before that and I was doing my best not to alarm the tiny humans. The pain was making it difficult, though, and I didn’t need to tell my wife out-loud that I was agitated. The doctor did not help. She had a thick Eastern-European accent and zero bedside manner.

“You’re a very big boy,” she said without introducing herself. “You’re not doing anything silly like creatine, are you?” I glared at her without answering that ridiculous question so she continued. “What’s wrong with you, then?”

I explained the whole sequence of events and then told her about my revelation that I had felt this way before.

“It’s happened a few times. I didn’t know what it was, but every time it’s happened I went to sleep and woke up the next morning feeling normal,” I explained.

“That’s not possible,” she dismissed my evaluation and then dismissed me, looking up at my wife. “Is there anything you would like to tell me? Sometimes they forget.” The doctor pointed at me as she made that statement.

Umm… Nurse, that’s “normal,” isn’t it?

For the next seven hours I battled back and forth with the hospital staff about my condition. I insisted that it was going to go away on it’s own, they insisted that it wouldn’t. From there the argument transitioned into my endless requests to fix the AFib and their insistence that they needed to “run some tests first.”

Around 3 AM I finally got some medicine for the stomach pain and drifted off into sorta-sleep. Then I felt the snap. At 4 AM on the nose I was jolted awake by a new feeling. I was exhausted, still a bit queasy, but… better. I looked up at my heart monitor and I could no longer feel the palpitations. As I squinted through the medication haze I squeezed the call button. A few seconds later the nurse walked in.

“That’s normal, isn’t it?” I asked as she walked up to my bed. “I guess you can’t do your tests now.”

They never figured it out

I was stuck in that bed for another 24 hours before I was released. And only then because I threatened to sue them for malpractice if they didn’t let me out. It felt like prison. But I can understand why they didn’t want to let me out. No one likes not knowing.

There was no medical reason for my being there. None of the numerous tests (there was a CT and many other in addition to the prostate exam) showed anything abnormal. Other than the fact that I felt like I was dying, I was normal.

As much as I despised the staff who “treated” me (still do actually) over those 36 hours, I understand their frustration. It’s one shared by every safety professional out there.

We’re not the gods we wish we were

We can’t control everything because we don’t understand everything. That’s a sobering reality. And it’s especially hard to cope with when something bad happens. But it doesn’t mean we stop trying. It just means we have to accept that all risk cannot be removed. The best we can work toward is creating a system that reduces those risk’s impact on people rather than believing the false dogma that we somehow have the power to eliminate all accidents. Anyone who believes that is possible is lying to themselves or (even worse) to everyone else.

As I was thinking about that event yesterday, it occurred to me that it changed my whole perspective. Prior to that day life seemed like a foregone conclusion. Now I don’t see a future. Don’t get me wrong, I’m not making a veiled cry for help with that statement. I just realize that there’s no grantee I’ll grow old and get to see my kids experience life. No one else get’s that certainty either. With that realization, it becomes all the more important to manage the risks we deal with on a daily basis. When you do, though, just remember you’re human. You’re not going to manage (or even see) them all.