Learning from the mistakes

Sukumar Mukherjee MD, FRCP(Lond), FRCP (Edin), HonyD.Sc (CU), FSMF, FICP
Former Professor and Head, Department of Medicine, Medical College, Kolkata, India
Consultant Physician, CMRI and GDDI, Kolkata, India

Errare humanum est (To err is human)

Latin Proverb

But people must learn from mistakes

It is commonly accepted that we should and do learn from our mistakes or missed opportunities as the proverbs from around the world show. From Cicero to Gandhi and Romania to China, received wisdom tells us that we honour our mistakes, that they can lead us to great learning. From my recall of past 87 years in my life’s journey some of my mistakes mostly inadvertent have surfaced in my personal and professional life which remains as eye-openers which are narrated below.

Audentis fortuna juvat (Fortune favors the bold)

Latin Proverb

After qualifying MRCP both from London and Edinburgh with special paper in Cardiology in 1967, I had the training in Internal Medicine as Registrar in Liverpool in 1967 and Cardiology Registrar in 1968-69 in London Chest Hospital UK. With further new job at hand as Cardiology Registrar in Brompton Hospital from 1969 I had to return to India in May 1969 because of expiry of WB Government study leave. I was transferred from Cardiology training at Brompton Hospital, London to Bankura Sammilani Medical College, Bankura by the Government order to act as teacher in Internal Medicine in sultry weather when Naxal movement was on. I was in great dilemma and it was also a great set back not to specialize in Cardiology which I earnestly enjoyed. Over and above my mother asked me to come back, whom I could not disrespect and refuse as her eldest son. My future to be a Cardiologist abroad was missed forever. Instead I stayed with my newlywed wife Bijaya at Bankura who was very supportive to me in teaching and training medical students in very odd circumstances during the period of 1970-1976. Then I was transferred to Medical College, Kolkata in 1976 where I worked as teacher in Internal Medicine till my retirement in January 1994 as its Professor and Head.

From 1980 onwards I got interested in Rheumatology with the persuasive influence of Prof. KS Bose, Professor of Orthopedics and Prof. Manjushree Mitra, Prof. of Medicine. At that time Rheumatology was in infancy in WB and State Branch was created. I got interested in teaching Rheumatology amongst the students and contributed significantly in State Branch. Ultimately I became President over the years both at National and State level and organized National conferences. I have made several publications and guidelines between 1985-90. I was fortunate to receive National M N Passey Award and Best Teacher Award in Rheumatology for my sincere involvement. It seems I am a Rheumatologist by default!

My learning points: Adaptability and perseverance for new openings

Life is short, art long, opportunity fleeting, experience treacherous, judgment difficult.

Hippocrates

Elderly obese Swamiji 92 yrs had moderate to severe melaena needing repeated blood transfusion over 10 days in 2001 when UGI and lower GI endoscopy revealed no abnormality. In absence of double balloon endoscopy and CT angiography at that time exploratory laparotomy was done with permission by Senior Surgeon and ‘Caecal’ Bleeding was detected but patient died post-operatively. This was extremely obscure cause which I missed.
Woman, 56 yrs, morbidly obese with long standing T2DM, Hypertension, Primary hypothyroidism presented with gangrene of several toes and fingers about 15 yrs back. Diabetes was a suspect and amputation of several toes and fingers were done in spite of conservative treatment. In view of upper limb involvement and low platelet count the patient was investigated further and found to have autoimmune disease (SLE and secondary APLA). She is on maintenance therapy now with immunosuppressives and oral anticoagulants besides control of metabolic disorders.
A young woman of 32 had biopsy proven TB lymphadenitis neck about 10 yrs back. Anti TB drugs was initiated but after 2 wks of initial response she came back with recurrence of fever and discharging sinus with pus. Investigations revealed sterile pus. Though Antibiotics were initiated empirically but no luck even after 2 weeks of therapy. Immune Reconstitution Inflammatory Syndrome (IRIS) was later suspected based on information from HAART regime and steroid was started to get over the problem along with ATD. The patient was cured.

My learning points: Keep thinking of even rarer possibilities when things are not progressing as expected.