Observing more senior physicians, students learn that their mentors and supervisors believe in, practice and reward the concealment of errors. They learn how to talk about unanticipated outcomes until a ‘mistake’ morphs into a ‘complication.’ Above all, they learn not to tell the patient anything.
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In 1867, Czar Alexander II of Russia sold off 586,412 square miles of his country to the United States for the fire-sale price of 1.9 cents per acre, or a total of $7.2 million – about $109 million in today’s money. Convinced that he had disposed of a glorified ice cube, the czar thought he had gotten the better end of the bargain, and many in the U.S. agreed. The journalist Horace Greeley disparaged the deal as an “inconvenient” purchase that offered the buyer “nothing of value but furbearing animals.” Today that inconvenient purchase, better known as Alaska, is worth an estimated $100 billion in oil and gold. In 2008, Forbes magazine described Alexander’s decision to sell Alaska as one of the ten worst business mistakes of the last 400 years.