David Beresford
Another Country
A wonderfully talented hockey-player at my boarding school went into hospital for a minor operation to relieve a pinched nerve and returned with one leg missing. A cousin who badly fractured an ankle during a rugby match hobbled out of a clinic sporting a broken jaw, having been dropped while being transferred to an operating table.
So it goes. It fact, so far does it go reported incompetence in the medical field that one cannot help wondering on occasion whether a system of random treatment would not attract better odds for a cure in the same way as, it is said, the best chance of enrichment on the stock exchange is the random purchase of shares.
A lucky dip at the entrance to hospital, perhaps? Porter in attendance: “… right, it’s out with your tonsils … you’ve had them out? … to the back of the queue … next?”
One exaggerates, of course. But the chances of misdiagnosis and inappropriate treatment do seem to be such that one has a rare moment of sneaking regard for the presidential pin-head (the one lurking around Washington, that is) for an initiative he has started aimed at cutting the number of medical blunders in the United States.
President George W Bush is trying to have a database set up on the Net to which doctors and other hospital staff would be invited to confess their mistakes on a confidential basis, instead of just burying them. The idea is that the authorities could then spot trends or patterns and act on them.
The electronic confessional would presumably need to be discreetly tucked away to save the patient, emerging from the gas and the operating theatre, the dispiriting sight of the surgeon waving his arms and mumbling away in a defensive kind of a way into the microphone.
Ludicrous though the proposal might seem at first sight it does seem to have the flicker of an idea buried in it, somewhere.
The confidentiality clause is self-evidently ultra vires of the Constitution with regard to the freedom of information. As such it should fall away as soon as statistical analysis by the database uncovers some such as a serial-amputator with a prejudice against limbs, or a brain surgeon with a fatal twitch. Instead, no doubt, popular demand will quickly result in its transformation into a rating system that will mean that medical expertise rather than a bedside manner and a vague resemblance to an actor playing the doctor’s part in a popular soap opera will be recognised and rewarded.
In time the maintenance of such a database will probably enable a prospective patient to punch into his computer a complaint of a twinge in the left side, to have a moment later to the accompaniment of trumpets and, no doubt, ads for mouthwash the announcement that the practitioner with the best record on twinges on the left is Dr So-and-so.
But why is the medical profession the first target of this presidential initiative on the Net? What about the business of presidency itself?
Judging from 20th-century experience political leaders are a far greater threat to lives and limbs than any doctor. Don’t we need more urgent help in spotting certain trends and patterns in that respect?
To take an entirely hypothetical example, imagine Bush were to suddenly announce, against the best of scientific advice, that he had discovered cigarette smoking had no link with cancer. Suppose the Secretary of State, Colin Powell, delivered a speech reading from a prepared text with a distinct Texan drawl denouncing the French as a nation of frog-eating wankers. And say the US intelligence services were discovered to be investigating, on orders “from the top”, a plot by Senator John McCain to overthrow the president.
Then our early warning database system putting together these individually subtle clues with the help of Internet search engines could start squawking, sending citizens stampeding to their nearest bunkers and the relevant emergency services hurrying to the White House.
Political leaders, doctors, judges, heads of emergency services, pilots people with the lives of other people in their hands would be the obvious first targets for such monitoring. But as the databases grow bigger, the Net becomes faster and its search engines more powerful, the opportunity will surely come when such early warning systems are of value in reducing risk at a more mundane level of social interaction.
One might be shaving, preparatory to going out for dinner at Greasy Joe’s, when the house computer chimes in to say that Joe’s Alsatian went missing on Monday and it wasn’t the first. Wedding bells might be ringing in her ears as she intones an appointment-reminder for her first date with Mr Right into her personal digital assistant when it squawks back to her that he’s on Viagra. He might be about to buy his dream car when a miniature earphone in his spectacles starts squeaking that the dealer has turned back the clock.
Crank the system up another few notches of power and sophistication “… been known to use too much salt”; “sometimes snores”; “suspected of consorting with Bulgarians …” and we will remember how blissful ignorance could be.
Perhaps we should take our chances with the medical profession. But what about the president?