Internal Bleeding: The Truth Behind America's Terrifying Epidemic of Medical Mistakes

by Robert M. Wachter, Kaveh Shojania

Imagine an epidemic that kills over one hundred Americans every day. Now stop imagining.

Each year doctors and nurses kill nearly one hundred thousand Americans. By mistake. They operate on the wrong patients, prescribe the wrong drugs, and leave instruments inside body cavities after surgery. Meanwhile, hospitals spend billions on new gadgets, marble lobbies, and slick billboards even as safety continues to be ignored.

Until now.

Internal Bleeding exposes the dark secrets behind the glistening facade of modern medicine. Doctors Robert Wachter and Kaveh Shojania, professors at one of America's leading medical schools and two of the world's foremost authorities on medical mistakes, shatter the silence to tell the dramatic and compelling stories of real patients betrayed by a system they trusted to save them.

Through these stories, the authors reveal the inner workings, gut-wrenching dilemmas, and heartbreaking tragedies of our overburdened, understaffed health care system. Internal Bleeding provides an insider's view of how professional caregivers think, feel, and operate-facts that every patient and family must know to avoid becoming just another "mistake."

In the groundbreaking tradition of Fast Food Nation , Internal Bleeding paints a vivid and unforgettable picture of a system gone terribly wrong, and what doctors, nurses, hospital CEOs, and policy makers must do to make it right.

Genres: Medical, Nonfiction, Medicine, Health Care

448 pages, Hardcover

First published January 1, 2004

About the author

Robert Wachter, MD is Professor and Chair of the Department of Medicine at the University of California, San Francisco (UCSF). Author of 300 articles and 6 books, he coined the term “hospitalist,” the fastest-growing medical specialty in U.S. history. He is past-president of the Society of Hospital Medicine, past-chair of the American Board of Internal Medicine, and an elected member of the National Academy of Medicine. In 2004, he received the John M. Eisenberg Award, the nation’s top honor in patient safety. Modern Healthcare magazine has ranked him as one of the 50 most influential physician-executives in the U.S. more than a dozen times; he was #1 on the list in 2015. His 2015 book, "The Digital Doctor," was a New York Times bestseller. His new book is "A Giant Leap: How AI is Transforming Healthcare and What That Means for Our Future."

Reviews

[Friscomama · Rating 4 out of 5]

This book about medical mistakes was written in 2004, so it's not quite up to date. For those of us who miss some of what goes on in the world, that's okay. It provided, for example, some context for the rush to get records computerized - because missing records can lead to negative outcomes. Broad coverage of various kinds of errors are brought to life with stories of specific people whose medical care had gone wrong. This technique made for some staying up past bedtime at my house.

At the end of the book, there are some suggestions of how to avoid some of the problems. For example, the breakthrough new product to avoid wrong-leg amputations is a permanent marker. As of the writing, some surgeons marked the leg to be amputated and others the leg to be left alone. Best to write "don't amputate this side" in case there is still no standard for this.

So if it's not going to scare you too much, I recommend it.

[Melsene G · Rating 4 out of 5]

This was another thoughtfully written book by Dr. Wachter. I have seen him speak several times and he is clearly a thought leader in the quality movement. As for this book, it covers the gamut of medical errors from prescriptions, wrong site surgeries, handoff issues, reporting, malpractice, and culture. If you're involved in healthcare in any way, the information contained here will give you a good foundation of why medical mistakes are made.

The book was written in 2004 so it is outdated to some extent because of the rise of the Internet and the smartphone. Many healthcare providers have implemented CPOE, EHR, etc., and have changed the culture within their walls in the last twelve years putting safety and quality at the top of their pillar goals. The last section of the book offers solutions and the Appendix has a nice list of reading materials.

[Mitchell Rubiano · Rating 5 out of 5]

Because I was only interested in reading actual stories of doctors making mistakes, I only read part 2 of the book.

Some of the blunders told in this book were so horrendous and fatal that my best piece of advice for people trying to avoid becoming victims of medical mistakes is to avoid becoming a medical patient in the first place. Important to say though, that we can't treat medical staff like robots who don't ever make mistakes. It's not fair to them.

[Jim Duncan · Rating 5 out of 5]

Get set of stories about the causes of medical mistakes. Published May 2005 and yet the underlying factors persist. Yes - CPOE is more widely available but Digital Doctor describes a new set of failure modes for medical errors.

[Elizabeth · Rating 5 out of 5]

This is a great book. It's much more in depth than Complications and has much less of a pop culcure feel.

[Bryn · Rating 5 out of 5]

Although it’s nearly two decades old as I’m writing this review, this book is still fascinating, informative, and important. It’s written with obvious extensive knowledge about the subject, but is communicated so that even someone who isn’t part of the health care system can easily understand it. The amount of wit and thoughtful comparisons both clearly illustrate the issues being discussed and serve to make this book far from a dry read. At the same time, it contains a discussion that acknowledges the nuances of medical errors and how to combat them, with very thoughtful responses to the myriad of problems described.

On the surface level, this is an interesting collection of stories about medical errors, but it’s also an honest exploration of the healthcare system and all those who work in it. It’s clear how much work and care was put into writing this book, and that’s something I very much appreciate.

[Sadie · Rating 2 out of 5]

interesting idea but was super outdated. Not as exciting a read as I hoped it would be

[Ahimsa · Rating 5 out of 5]

frightening!

[Claire · Rating 3 out of 5]

I had to read a chapter for an 'interprofessional' school event and that chapter was so interesting that I had to read (skim:) ) the rest of the book.

[Diana · Rating 3 out of 5]

Had a lot of interesting info but I have to admit that I did the old "scan & read", "scan & read" thing.

[Carissa · Rating 2 out of 5]

I gave up on this one and bookmooched it. Read like a dissertation on hospital improvements. Some good case studies/stores, but overall, bleh.