Internal Bleeding

Internal Bleeding: The Truth Behind America’s Terrifying Epidemic of Medical Mistakes delineates flaws in the American medical system that lead to mistakes, from minor to catastrophic. Authors Robert M. Wachter and Kaveh G. Shojania, both physicians and patient safety experts, discuss the U.S. medical system; present case studies of various types of medical mistakes, emphasizing why they happen; describe ways society reacts to mistakes, especially dramatic cases; and conclude with recommendations for change. They describe the kinds of errors that make headlines, such as a major operation done on the wrong patient; however, they also detail the many minor errors that occur in health care facilities daily, explaining how factors from human error to unconscious biases affect medical decision-making.

Behind a sensational title and cover art lies a thoughtful, well-developed and articulately- presented study of why medical errors occur, with an emphasis on prevention. The authors’ goal is not blame, but rather understanding. All sides of the cases presented are respected. The authors show how seemingly egregious error may result from flawed yet reasonable logic; apparently obvious “cures” (such as shortening residents’ working hours) are soberly demonstrated to be double-edged swords that can be equally hazardous. Readers will be left not with fear of a “terrifying epidemic” but with renewed confidence in the amazing achievements of the medical profession, particularly its efforts to avoid these kinds of mistakes in the future.