Regrets

By

Leonard Zwelling

“Je ne regrette rien.” That may be fine for Edith Piaf, but not for me and not some patients either.

Drs. Jerome Groopman and Pamela Hartzband write a brilliant opinion piece in the New England Journal of Medicine on October 19 entitled “The Power of Regret” noting how the push to include patients in medical decision making can also lead to all kinds of regrets if the therapy chosen fails, if the therapy works but side effects are worse than the disease or even, at times, if the outcome is good, but would have been good even without the extensive surgical procedure for which the patient opted. You get the drift. Medicine is full of disappointment on the part of both patients and doctors, and sometimes the disappointment is larger and includes true regret.

http://www.nejm.org/doi/full/10.1056/NEJMp1709917?query=featured_home

In my life as a patient, a doctor, and as a regular human, I have experienced tons of regret. I have treated people badly without reason. I have made errors in judgment about research that I performed and about care that I have rendered. I made severe errors in judgment about my own care that led to poor results and additional hospitalizations. I surely defended my superiors as an administrator when the right thing to do would have been to resign, but I liked the job too much. I regret all of that. Those who say they have no regrets are made out of better stuff than I.

I say this in preparation for the coming of a new administration at MD Anderson. Being that the new president, Dr. Pisters, is human, he will undoubtedly make mistakes. I hope he will own up to them when he does unlike his predecessor. But let’s wish that he has no regrets about returning to Anderson or making tough calls, which he will inevitably have to make. He can be disappointed, but let’s hope he has no regrets.

Dr. Pisters has some tough decisions to make soon: (1) who to appoint to key positions and how much leeway to give each of them as they pursue his vision; (2) how to return patient care to its rightful place as the main activity of MD Anderson and how to reward those who do it well; and (3) how to optimize profitability and costs in a very rapidly changing health care environment.

If Dr. Pisters seeks the help of the faculty and its leaders, he may make mistakes, but he is unlikely to experience regrets. The greatest regret of any decision I ever made as a vice president occurred when I did not follow the advice of those around me in hiring someone. That I regret. So essentially, it is hubris that can cause regret and listening, inclusion and humility that can prevent it.

Read the piece by Groopman and Hartzband. It is worth the time and you will have no regrets having read it.

Leonard Zwelling