As an engineer, I have always placed far more faith in technology than in people. Many in the brave new world of “evidenced-based medicine” feel the same. But sometimes simple “people solutions” work where nothing else will.
I live in a jungle of pine trees at 8,500 feet above sea level, 40 miles southwest of Denver.
It is a very beautiful place, but every resident’s worst fear is forest fires that can destroy your home and your view before you can lift a finger to stop them. This is a story of two radically different approaches to the problem of forest fires.
Joe was an engineer who built his dream home in a valley southwest of Pine, Colorado.
He fully recognized the danger of forest fires and applied his best engineering to the problem. For starters, he built his house out of concrete instead of wood. He roofed it with concrete tiles. As extra security he installed fire sprinklers on the roof in addition to inside the rooms. To feed the fire protection system, he installed a 10,000-gallon cistern and electric fire pump. Knowing that pumps are worthless when the power goes out, he installed a diesel-powered emergency generator. Joe’s insurance company loved him and gave him their lowest rate. In the summer of 2000, the High Meadow Fire roared through Joe’s valley. Unfortunately the fire was so intense that it sucked most of the oxygen out of the air and Joe’s fire pump wouldn’t start. The intense heat radiated through his windows, setting the drapes and furnishings on fire. Joe’s dream house burned from the inside out.
My friend Rodney was a Cajun surveyor who worked for us back then, who also built his dream house in the little town of Westcreek. Now Rodney had spent a little time in engineering school but never quite graduated. He was a very clever, very likeable Cajun who was positive no matter what crisis was brewing. In 2004, the Hayman Fire came roaring through the Platte Valley. Rodney rushed home as soon as the fire broke out. For the first two days he ran bulldozers for the county, building fire lines. On day 3 the federal firefighters showed up in force to try to save the day. They immediately shut down all the county operations. Rodney was dejected but not beat. His wood frame house sat high on a hill with a great view of the entire valley, so Rodney volunteered the use of his home as a federal fire command center. For the next three days Rodney fed the firefighters all the steaks and beer they could eat. On day 7, the wind turned towards Rodney and he was ordered to evacuate for the third time that week. On his way down the mountain with his valuables and animals in his truck he met a large crew of federal firefighters. They stopped briefly and said, “Don’t worry, Rodney. We will save your place!” When they got to Rodney’s house they set a backfire on the uphill side and circled the downhill side with their trucks. Rodney only lost 13 trees. His neighbors weren’t so lucky.
After three years of medical research I have come to believe that a patient’s best tool for receiving high-quality care is to treat your medical providers as my friend Rodney did. Get to know them before you go in for surgery, treat them with kindness and respect, put yourself in their Crocs, and watch out for their needs. Imagine how difficult it must be to face a steady stream of complete strangers every day with a bewildering number of serious health problems, knowing that your simplest mistakes can cripple or kill them. When you see something they might be doing wrong, gently remind them in a kind way. Much of what separates good care from poor care is how much time the staff is willing to give you. Being human, they will naturally spend more time with the fun, kind patients than with the angry, bitter ones.
One of the benefits of working on Colorado’s infection reporting committee is that I get to know the top infection prevention professionals in all the major hospitals. I cannot think of any better friends to have when you are rolling into an operating room. Patient safety is far more than systems, slogans, procedures, and checklists. It really comes down to two people putting aside their own interests and finding the courage to help cure each other.
Kerry O’Connell, June 2008