7 March 2024

I started writing this blog with my "greatest mistake" in mind. I was trying to think of the worst thing I had ever done but it didn’t quite turn out how I thought it would.

I can think of mistakes, lots of mistakes but there was 1 relatively small mistake that has just stuck in my head for over 30 years. What I realised through writing was the difference between mistakes and regrets.

It was 1992 and I had been a House Officer for just a few months. Winter had come, the corridors were dark and cold between wards and residence. I was on call and onto the third shift of nurses I had seen since starting the day. I was calorie starved, hassled and receiving calls direct from GPs. We were "on take", you took patients when asked, not there to argue about it. We recorded patient details and directed the GP for where the ambulance should go. There were no bed managers, I just had my sheet of A4 carefully folded into 4 to fit my white coat top pocket. This sheet helped me keep track of where all the beds were, it was updated every time I went through one of our medical wards.

My bleep issued its brain penetrating whine and flashed a 4-number sequence in burning red LEDs. It was switchboard and yet another patient needed to come in. I called them to be connected, got my A4 out and introduced myself. I was surprised to hear a loud “It’s Tippers! Wondered when I would finally speak to you, this should be easy then.”

Dwelling on regrets

It was Alex*, a brilliant local GP, rugby coach and the dad of 1 of my school friends. Alex had taken me to see a comedian when I was younger, he bought me fish and chips afterwards, they were great. He was also in the same year as my dad in medical school – hence the “Tippers”, my dad's nickname.

He needed to admit a man with prostate cancer who was in great pain and couldn’t walk. Clearly, he needed sorting out urgently. I had recently discovered that our hospital had clinical oncologists and I found myself arguing with Alex that the best thing for this man would be for him to call them instead. It was the middle of the night, what the heck was I thinking trying to bounce this? Why was I arguing with a skilled, experienced GP who also happened to be someone I had close family and personal links with too?

"You maybe wouldn't believe how often I have thought about this incident, odd how it keeps appearing."

In proper Alex style, he slammed the phone down on me. I absolutely deserved it.

I remember dwelling on this for weeks, thinking I was bound to get another admission from Alex at some point in my house job. That this would give me a chance to apologise and be the person I should have been, the doctor I aspired to be. But it never came. I eventually left the area, I never mentioned the incident to my dad, I was too embarrassed.

To this day I have not had the chance to apologise to Alex for being so difficult and obstructive. I really should have made an effort sometime in the last 30 years to sort this out. Too much time has passed now, it is impossible to fix this now. You maybe wouldn't believe how often I have thought about this incident, odd how it keeps appearing. I really hope he gets to read this blog, might be the best I can do now.

A mistake or a regret?

So that was the mistake that has never gone away – the way I spoke to someone 30 years ago and my failure to apologise. I can never fix it. I can never fix what Alex must have thought about me. A mistake that left someone thinking badly of me and a mistake that affected someone's care. I could so easily have done something to remediate, but I didn’t. I think this all makes for regret. More than just a mistake, regret is deeper, lodged and immovable.

"Your decisions become those to avoid regret and your practice has to continually improve to avoid mistakes."

We learn from mistakes, you make things better. You apologise, reflect and improve and the mistake leaves you. Regrets gnaw away in the mind, they don't go away, they eat at something fundamental in your thoughts. We tire our thoughts out, believing we could have done things better, when the reality is of course that you can never change the past. The mistakes that become regrets are what influences so much of what I do. Your decisions become those to avoid regret and your practice has to continually improve to avoid mistakes.

Lessons learned

So, what have I learned from all this?

  • Be nice to people. That means courtesy, consideration and respect. The things I regret most are all around the way I have spoken to people.
  • Listen to your colleagues and value their opinions. Don’t be a smart alec, thinking you know better.
  • Be accessible and supportive, you don’t gain from having the reputation of a wall.
  • Keep patient care at the front of your mind, not your hopes for a quiet night.
  • Apologise and make up for your mistakes as quickly as you can. Regret is a horrible thing.
  • Watch out when you are tired, hungry and hassled. Your guard is down and your emotional intelligence can fail.

Writing things down makes you think, and I think I just paraphrased a heaving great chunk of the GMC's Good Medical Practice.

*Name changed for the publication of this blog.