Do We Only Care When the Privileged Die?

I have no doubt that Lewis Blackman was a wonderful young man.  He beams out of all the pictures included in The Faces of Medical Errors, a charismatic, good-looking teenager.  Despite our tendency to deify the dead, I have no trouble believing all of testaments to his intelligence, character and joy.  Based entirely on the courage and poise of his mother, I’m sure all of the praise heaped upon him in the opening minutes of the video cannot begin to touch the reality of his potential as a human being.

And yet, as these accolades rolled on, I felt a growing annoyance pulsing in the back of my skull.  The purpose of the film was to viscerally connect us to the consequences of medical errors, to strip away the comforting veneer of facelessness from patient safety lapses and give us a regrettable casualty we could fixate on. As I gazed at the pictures of Lewis floating by, I couldn’t help but wonder if the video was unintentionally striving to sell us on the “regrettable” part of the formula. Lewis could have been my little brother.  He was athletic, talented Caucasian male born to educated parents who entered the hospital for an elective procedure.  Despite our best efforts, race and class are difficult to eradicate from our visceral reactions.  Even as I was moved nearly to tears by the Lewis’s story, a dissenting voice was growing in strength

What if Lewis had been a poor African-American boy, in the hospital for a sickle crisis?  Or a homeless person, in the hospital for an OD? Or an undocumented immigrant, in the hospital giving birth? Or a teenage drug dealer, in the hospital for a gunshot wound?  Especially in light of recent events in Florida, it is difficult to argue that, as a culture, our assignment of blame is unbiased. Rationally, I believe that the death or injury of any patient due to a preventable error is inexcusable.  Each is equally a tragedy.  But I cannot with perfect honesty claim that any of the stories above would impact me the way Lewis’s did (I am interested if any of my colleagues here at Telluride with more diverse backgrounds feel differently.  Do I only care so asymmetrically about Lewis because, to paraphrase President Obama, “ten years ago, Lewis Blackman was me”? Please let me know your thoughts on this.).  The realization made me equally sad and angry.  I was angry that the film was pulling strings whose very existence filled me with shame.

This is not, however, meant to be an analysis of class relations.  I’m writing about this internal struggle because of the revelation that followed on its heels.  Lewis was, by most estimations, a child of privilege.  While this does not make his death any more tragic, it does make it more problematic.  Lewis entered the hospital with powerful advocates who, while not medically trained, were educated and assertive.  If Lewis, backed by a mother who understood what his vital signs meant and was unafraid to speak up for her son, could fall victim to a harmful medical error, what chance do the indigent, the elderly and the handicapped have in our medical system?   What a call to action this is!  Our methods of healthcare delivery are capricious to the point of transgressing  our normal social constructs.  This realization allowed me to harness the emotional power of Lewis’s story to remind myself that Lewis, compared to hundreds of other patients in the hospital that day, had an excellent chances of walking out unscathed. Scores of more vulnerable patients are exposed to the same systems that caused his tragic.   If we truly hope to do no harm, Lewis’s story should serve as a constant reminder of how far we have to go to protect all of our patients, regardless of the situation into which they were born.


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