I still remember taking care of a particular patient when I was a medical student. She was a middle-aged woman with cyclic vomiting syndrome who presented with nausea, vomiting, and abdominal pain. The plan was the same as always: nothing by mouth, intravenous fluid, antiemetics, and discharge once she could eat. On hospital day 2 she suddenly developed chest pain. An electrocardiogram (EKG) revealed ST-segment elevations, which prompted emergent cardiac catheterization. I reviewed her admission EKG and realized it had identical ST-segment elevations. I became nauseated myself, because no one from our team had looked at the initial EKG. The angiogram excluded acute coronary syndrome, but the guilt of a potentially tragic mistake remained. I wanted to share this experience with my colleagues so we could learn from it. I asked a colleague for the best forum to discuss our mistake, and my colleague gestured “hush” and said, “There is no need to tell anyone because she didn’t have plaque rupture.” I was confused by that reaction. Was I to be ashamed of my mistake?

我仍然记得当我是医学生时要照顾特定的患者。她是患有周期性呕吐综合征的中年妇女，伴有恶心，呕吐和腹痛。该计划一如既往：没有任何东西可以通过口服，静脉输液，止吐药以及一旦她可以进食就排出。在医院第2天，她突然出现胸痛。心电图（EKG）显示ST段抬高，提示紧急导管插入。我查看了她的入院心电图，发现其心电图段抬高相同。我自己感到恶心，因为我们团队中没有人看过最初的心电图。血管造影术排除了急性冠状动脉综合征，但仍然存在潜在的悲剧性错误。我想与我的同事分享这种经验，以便我们可以从中学到东西。我请一位同事讨论建立我们错误的最佳论坛，然后我同事示意“安静”，并说：“没有必要告诉任何人，因为她没有斑块破裂。” 我被那个反应弄糊涂了。我为自己的错误感到羞耻吗？