Mistake Making

on human error

Hi friend,

In March of 2021, I had an operation to repair my hernia. The operation had been set for April of 2020, but we all know what we were doing then, and it wasn’t going into the hospital for elective surgery.

This was an incisional hernia that was a result of my liver transplant — it was uncomfortable and unsightly — it stuck out of my middle like I had swallowed a golf ball. It prevented me from exercising freely, and it made me self-conscious. I lovingly referred to it as my alien baby, and I probably could have lived with it. I just didn’t want to. The surgery wasn’t a total success, and I still have a muscle mass there — it’s just a lot less pronounced and a little less uncomfortable. It lives at the apex of where my Mercedes Benz scar is.

To have an operation, of course, you usually have to be hospitalized — I was at the Royal Free in Hampstead. It was a new experience for me. The last time I had been hospitalized in the UK, it was for something really minor at Chelsea Westminster when I was 21. In and out. My best friend came to visit around that time and helped take care of me. We lay in bed watching every episode available of Grey’s Anatomy and she helped pack my wound — true friendship. So this time, nearly 15 years later, was the first time I spent considerable time in a hospital in the UK as a patient. I spent a full week there, and since it was during a time when COVID was still pretty rageful — I wasn't allowed to have any visitors. Less than ideal.

In my previous hospitalizations, I’d had so many guests sometimes it felt like a full-time job just managing them. An embarrassment of riches. This time it was very quiet and I realized how much I relied on visitors to pass the time. Luckily, I did have three other ward mates to entertain/torture me. There was a woman there who had recently had a liver transplant, and she was absolutely miserable. She really felt like the world was against her. She didn't make it any easier on herself because she was extremely unpleasant to be around. Anytime anyone else asked for something, she took the opportunity to get the nurses to also pay attention to her by incessantly badgering them. Every single time I asked for pain meds she would suddenly shriek out in pain, and tell them how, she too, was in pain and she, too needed pain meds. It was extraordinary to witness.

It was a long week with a few bright spots. A dear friend of mine delivered a clandestine care package with snacks, tea and a good meal. She walked up to the ward, which wasn’t allowed at the time. I was so grateful she broke the rules: it made my week to get to see a friendly, familiar face. Another friend gave me her Apple TV login, and I watched the entire first season of Ted Lasso high on painkillers, which meant I kept getting distracted and had to rewatch entire episodes. I filmed some content that was completely unsuitable for public consumption, and luckily had the wherewithal (despite previously mentioned painkillers) to refrain from posting it.

When I returned home, it felt great. My friend picked me up in her cute little blue car and drove me back to East London. I cried in the car, and she was used to that with me, so she didn’t mind. I hadn’t healed quickly during that week, but again, we were in COVID time, so it's not like there was much to do—I’d have time to heal. Another friend was there when I got back, and she helped me into the shower. My flatmate made me dinner—a gourmet delight of butternut squash soup with homemade croutons. But then, the following evening, the hospital called me and told me the bloodwork they took the morning I left showed my liver numbers were off. The doctor on the phone said I had to come back that night so they could monitor me and find out what was going on.

I’d been in this situation before, and there was no fucking way they were getting me back to Hampstead. I could tell by the tone of his voice that this was a baby doctor—he was a registrar (sort of the equivalent of a resident in the US, but more specialialized). It’s always the baby doctor who has to make these types of phone calls. I told him I didn’t want to come back that night. I knew what would happen if I arrived there at 10 pm. I would simply have to wait until the morning to be seen.

“Please, please let me come back tomorrow morning.”

He pushed back and said:

“It would be a lot better if you came in tonight, that way we can get your blood taken as soon as possible.” Better for who, man?

“But none of the liver team is in tonight, so I wouldn’t get an answer until tomorrow. I think it would be a lot better for my liver to sleep in my own bed.”

Silence on the line and a heavy sigh.

“Ok, let me check with the consultant on call and call you back.”

I hung up the phone and started dry heaving. Sobbing. A wee bit dramatic.

He called me back a few minutes later and said:

“Okay, I’ve spoken to my consultant. You can come in tomorrow morning but you have to be here 6 am.”

I thanked him profusely and said:

“Absolutely, no problem.” Can’t wait babe. I gave myself a silent pat on the back for advocating for myself and then I freaked the fuck out.

I sat in bed crying uncontrollably and sent my flatmate a WhatsApp telling him what just happened. He knocked on my door: the poor guy had no idea what to do with me. He hugged me awkwardly and patted me on the back, which was the most hugging that we'd ever done. At one point during lockdown, I asked him to hug me because I had been so touched starved for so long. It was next to the fridge, which is where we would usually meet: he did it begrudgingly, rolling his eyes at how touchy-feely I am. This moment and the ones that followed during my recovery showed me that he cared for me, which was a relief (I was not just another body in the room next door).

Back to the hospital we went. He ordered a Zipcar and drove me back to the hospital at that ungodly hour. I sat in A&E, waiting, as I knew I would, for someone to come see me. A nurse came to take my blood. They put me into my own room, and I prayed to stay there forever, never to interact with another patient (an impossible prayer).

After a couple of hours, the consultant on duty came in and praised my prowess: “I heard you very sensibly told my reg that you wouldn’t come in at 10 pm.” I felt fully vindicated. Not my first rodeo, babe. She said they’d have to wait until my blood came back to look at the numbers.

I sat and I sat. I waited, and I waited. And I worried. I worried that my liver numbers were up and that I was about to descend into liver rejection. Again. That's what the numbers said. The numbers don’t lie. Did I bring this upon myself by wanting that hernia repair? Is that why my doctor in New York was reluctant to do it? (It wasn’t). This was my fault. The numbers spelt R-E-J-E-C-T-I-O-N.

My mind wandered to what it was like in 2016. I returned home after a day at work and dropped my bag in the front hall of my parents’ home. I held on to the side of the wall — suddenly so dizzy. I went to my bed, the place where I’d spent the better part of the past six months. Suddenly there was a rash all over my arms. Suddenly I was vomiting. Then yellow. Then suddenly, I was back in the hospital, going for an MRI. And then, suddenly, I was told that my liver was no longer functioning in my body. None of it was really sudden at all, but it felt like it all happened in a matter of minutes.

I knew the private room was too good to be true — after a couple of hours, I moved to a bed on a ward. As I sat in the brightly lit ward in the basement of a hospital in leafy Hampstead, I worried that the same succession of events was about to unfold. It was all a bit baffling — because I didn’t feel sick, just a little sore. I went to the toilet and locked the door. I lifted my shirt and lowered my leggings. No rash. I peered closely into the mirror. No yellow eyes. I placed my hand on my right side just below my rib cage, where my liver is. I asked her if she was failing. She didn’t respond.

There was a woman on the ward with me who didn't speak English and couldn't communicate what it is she needed. No one spoke her language. And I was reminded of the woman in the step-down unit when I was still being tested and how she had a Mandarin interpreter come in. And how scary it must be to be in a hospital and not understand the language. Even when I speak the language, I often feel like they speak in tongues.

Around 1 pm, a doctor came in and told me that actually, they had made a mistake.

“Sorry, what?” Excuse me, what? You made a mistake?

She told me that somehow my blood samples had been switched.

Excuse me, what? My blood samples had been switched. No, no, no, no, no, no.

Are you kidding? She didn't apologize. I think to apologize would admit fault, and in that context, you cannot be at fault. Did she not know the absurd drama that unfolded in my mind?

Ultimately, I didn't care. I was just relieved that I didn't have to descend to that level of failure. I didn't have to face a rejection episode. My organ was still in full cooperation with the rest of my body. They discharged me and sent me home with little to no fanfare.

I suddenly felt silly for the breakdown in front of my flatmate. I had shown how deeply afraid I actually am of getting sick again. How my trauma actually simmers on the surface and informs so much of what I am willing to do in the world.

It's so easy to think that our systems — like a hospital — are infallible. Yet we see them constantly malfunctioning. When mistakes happen at such a high level, which they often do — it helps me feel better about the ways in which I mess up. It’s not easy to admit when you make a mistake, but so much relief is available when you do. There's so much learning in failure.

With love,

Nora