Fallibility
FALLIBILITY
I can say a lot of things about working as a doctor in the ED, but one thing’s for sure: it’s one of the most humbling jobs out there.
In just one day, we get to see the full spectrum of humanity. Patients come to us at the end of their lives, while others come to start their lives all over again. Just when everything we do seems futile, something else comes along that makes it all seem worthwhile. It’s a constant struggle between fortitude and fallibility. It really puts life into perspective.
And being one of the mediators between life and death? The word ‘humbling’ doesn’t even come close to describing the privilege that comes with this responsibility. Though I swore never to let medicine overtake the other aspects of my life, I have never taken that privilege for granted. In fact, I still wanted to be the best doctor I could be.
The God Complex
Back when I was studying in Cambridge, one of my mentors told me something that stuck with me: “The best doctors are the ones who remain curious and humble throughout their careers.”
As a junior doctor, I had no trouble with the curiosity part. But the humility? Oh boy. I was cocky and arrogant, and I used to think I knew it all – though I always did my best not to let it go to my head. I had nothing else going on in my life back then, so of course I took enormous pride in doing the one thing I valued above all else.
But after my gap year and two years of working as a BST? Let’s just say those three years humbled me in more ways than one. For starters, I realised that medicine is a job much like any other. Good luck trying to do your job as a doctor without nurses, carers, cleaners, clerks, radiographers, physiotherapists and all the other essential staff who keep a hospital running. Every single role is necessary, and doctors are no more special than anyone else on the team – a concept that was foreign to me after using Grey’s Anatomy as my roadmap throughout medical school. “Anyone can fall in love and be blindly happy. But not everyone can pick up a scalpel and save a life.” Those words, spoken by Ellis Grey, were my main driver. They were what made me think doctors were gods.
But that was just the spoiled, sheltered view of someone who had never stepped outside the four walls of a hospital. After leaving the healthcare system and then returning with fresh eyes and a completely different mindset, I understood that doctors were just human. And, unfortunately, we do not stand on a pedestal above everyone else.
The Comfort of Infallibility
And that pedestal? It isn’t built by doctors alone. People need us to stand on it too. To anyone who has never seen what happens behind the four walls of a hospital, the idea that doctors are not gods – and that we make mistakes – can be deeply unsettling.
When someone’s frightened, in pain, or watching someone they love dying in front of their very eyes, the last thing they want is uncertainty. No one wants probabilities, differential diagnoses, or a doctor admitting that they’re not entirely sure what happens next. They want someone to take control. Someone who understands what’s happening, knows exactly what to do, and can promise that everything will be okay. In those moments, believing that doctors are somehow more capable, more certain, and less fallible than everyone else is necessary.
Relatives need to believe that someone is still in control when their world is falling apart. Hospitals need the public to trust that the people making life-and-death decisions know what they’re doing. Even doctors need to believe it sometimes, because walking into every shift fully conscious of everything that could go wrong would be completely paralysing. The myth of the infallible doctor gives everyone a sense of order in situations that are often chaotic, unpredictable and deeply unfair.
And so, we learn to perform with certainty. We speak confidently, make decisions quickly and reassure people even when part of us is still questioning what’s happening. Not knowing is a sign of ignorance and incompetence. Asking for help can be mistaken for weakness. Taking time to reconsider something can look like hesitation. Patients want confidence, hospitals reward decisiveness, and doctors quickly learn that vulnerability is not always received kindly. Eventually, the performance becomes so convincing that everyone – myself included as a junior doctor – starts to believe it.
But there is a dangerous side to needing doctors to be gods. Gods aren’t allowed to make mistakes. They aren’t allowed to miss a diagnosis, choose the wrong treatment, overlook a detail or simply be defeated by a disease process. Once we place doctors above ordinary human fallibility, every bad outcome needs a villain. Mistakes become moral failures, uncertainty becomes negligence, and admitting that something went wrong can feel like destroying the trust on which the entire system depends.
I do get that the kind of unquestionable faith some people put in us comes from a place of hope and idealism, and as much as we all want to live up to those incredibly high expectations, it’s sometimes impossible.
The Courage to Admit a Mistake
That is the contradiction. We know that doctors are human, yet medicine is built around the expectation that we must act as though we are not. Admitting our fallibility can feel as though it cheapens the value of life itself. Why would anyone put their life in the hands of a mere mortal?
At least that’s what we’re made to think during our training. That the cost of our mistakes are far too high to ever allow ourselves to make them. But is that even close to being possible? That, for me, was one of the hardest truths I had to face. That we are as capable of error as anyone else. That we are not gods after all. That, despite everything we do, patients will die. And that sometimes, one of our own decisions or mistakes may play a part.
It was one doctor who made me realise this: a senior anaesthetist who confided in me about a mistake that could have had catastrophic consequences. She had prepared the drugs she would need during a routine operation and laid the syringes aside. One of those syringes was accidentally switched with another by some other staff member and, in the rush of the moment, she administered it without double-checking. Luckily, it contained only saline, and the patient came to no harm. But looking back, the syringe she picked up could have contained something far more dangerous.
Had she told me this story a few years earlier, I probably would have judged her. Why would a senior come to a measly junior to confess her mistake? How weak! And why did she make such a mistake in the first place? Aren’t we meant to be infallible?! That is probably what would have gone through my mind back then. But now? I nearly fell apart. I came this close to giving her a hug when she told me. Being that vulnerable was a mark of strength, and she earned a whole new level of respect from me that day.
I reassured her and told her that, with the job we do, it is astounding that we don’t make even more mistakes than we actually do. While we can do everything within our power to limit these mishaps, there is only so much any one person can do because, at the end of the day, we are only human.
Only Human
And mistakes in hospital? Sometimes I wonder how on earth we don’t make way more mistakes than we already do. I mean, come on!
Multitasking doesn’t even begin to describe how we operate in the hospital. I sit down to write a note, and a nurse comes over to ask what the next step is for patient A, even though I had already run through the whole plan before sitting down. I start typing, only for a relative to come over and ask where patient B is. I redirect them to the lead nurse and continue typing. Then the software crashes, so I have to log back in and start from scratch. Another nurse tells me that patient C is in pain and needs analgesia. I stand up, grab a treatment chart and scribble down a prescription before sitting down to return to the note. A few minutes later, a junior doctor comes over to discuss patient D. Oh, and patient E is having a seizure and needs someone there stat!
Is it so hard to imagine forgetting a detail or two in patient A’s note when, in the space of a few minutes, I have had to deal with patients B to E? I don’t think so. Nor do I blame my relative lack of superhuman multitasking abilities. You see, the human brain cannot focus on two complex tasks at the same time. What we call multitasking is actually rapid task switching, which wastes time, increases errors, and causes mental fatigue. So, to that effect, trying to multitask in order to be more efficient means we’re just kidding ourselves. That said, do we have any other options?
The system is flawed, and I will never accept anyone telling me otherwise. We are human. We can only do so much. And, more importantly, we are just as fallible as anyone else. Sure, the price of that fallibility is much higher in medicine, but the longer I practise, the more I realise that this is precisely why humility matters. Accepting that we are fallible does not mean accepting preventable harm. It means building safer systems, double-checking ourselves and one another, and learning openly when something goes wrong.
We will never be superhuman. But we can make it far harder for an ordinary human mistake to cost someone their life. We will make mistakes because we are not gods. But patients do not need gods. They need doctors who are trained, careful, honest and accountable. They need people who are confident enough to act but humble enough to reconsider, ask for help and admit when they are wrong. That might be less comforting than believing in infallibility, but it is far safer. The pedestal only offers comfort until someone inevitably falls from it.