How Dr. Martin Luther King Jr. inspires me to dream for ‘Zero Harm’ in healthcare
As we remember Dr. Martin Luther King Jr. today, I could not let this day go without sharing my dream with you. His ‘I have a dream’ speech is remembered by many, inspires many, and will keep giving hopes to many to dream. His eloquent description of the dream is so powerful, courageous, and meaningful in so many ways.
I am not as famous as he is, as influential as he is, or as courageous as he is. All I dream is that you, I, loved ones, and everyone feel safe when we walk into a place where health and care are expected as patients and healthcare professionals feel safe to speak up when they make mistakes. We accept and realize that we are all humans who want to be cared, be healthy, and live fuller lives.
Safety is one of the basic human needs. Some of you may be familiar with Maslow’s hierarchy. Safety is the second most needed layer after physiological needs of air, food, water, and shelter. Without safety, our other needs above that layer, and even the bottom layer can be affected and challenged.
Healthcare needs to be a lot safer than now. After the landmark paper, To Err is Human by the Institute of Medicine in 2000, you may have heard the shocking statistic that the third leading cause of death after heart disease and cancer is from medical harms and errors. The number (anywhere between 250,000–440,000 lives per year) is argued by many in healthcare and around as an overestimate. However, I would argue it could be an underestimate as there is no right way to measure the number. A person like my dad, who lost his life even before receiving the care he wanted, should he be counted? I would say yes because he suffered numerous times from gaps, and the care he wanted could not be provided when he needed it. Inaction is also an action, and we shall not discount the power of such, as we demand justice and equity in healthcare. Zero harm does not mean nothing bad happens; when something does not go right, patients are acknowledged as that is the right thing to do. When the acknowledgment is missing, it becomes harm.
I painted the above on a back of a jacket before the pandemic, precisely for the World Health Organization (WHO) designated the first World Patient Safety Day on 9/17/19, as an artist of the Walking Gallery of Healthcare of Rev. Regina Holliday, a patient advocate and now a reverend. I attended the Patient Safety Movement Foundation’s Mid-year ”Plan to Zero Harm” event, and I specifically painted this jacket to wear it that day.
The title of the painting is No Mud, No Lotus: Journey to Zero Harm. I used the metaphor of the lotus for the painting. The lotus takes a painstaking journey in the mud and water to bloom into a flower above the water, just like how patient advocates have chosen the journey to tell the world for decades for safety and quality improvement of healthcare and make a difference. If you look closely at the jacket, I have names of patients who were harmed either on the roots (those we lost) or close to the roots (those who survived but permanently affected and advocating for patients). Stems directly from the roots have names of the patient advocates, usually, family members of the harmed , who continue to advocate for patients like you. The sun resembles the smile of Lewis Blackman, the son of Helen Haskell.
Helen has been advocating worldwide after Lewis’s tragic loss from a drug adverse event after elective surgery. An anti-inflammatory medicine called ketorolac caused him to bleed, and her concerns were not heard by medical staff. Her tireless work for patient safety is inspiring and remarkable; she amazes me every time I speak with her with so much knowledge about patients’ safety in the world. I wanted to create something meaningful for patient advocates because their continuous efforts in patient advocacy someday will bloom into flowers, although so difficult and painful. As Lewis smiles from the above, we will someday get to zero harm because these advocates continue to speak up their experiences for you. It may seem like an impossible goal. However, if we don’t dream, we will never get there. Just like Dr. King Jr inspired us all to dream, we will never have a goal to reach if we don’t dream.
Why a painting on a jacket instead of a canvas? This brilliant idea of Rev. Regina Holliday is amazingly a product of how, what, and why of patient advocacy to me — how art can restore empathy so healthcare can heal itself.
That’s right. Our healthcare needs to heal first before we can take care of patients well. Or I should say, our healthcare needs to put patients in conversations about designing healthcare to make a safe environment for patients and all who care for patients, including healthcare professionals and caregivers. This can mean a variety of healthcare improvements, but most importantly, take care of every human being in the interactions as a human with a name and feelings.
Regina’s husband, Fred Holliday, experienced many gaps in care while living, consisting of 11 weeks of continuous hospitalization across 5 different facilities. The experience inspired her to paint jackets after he passed away; she painted more than 400 jackets worldwide so far, helping other advocates tell their stories through her art. When Regina volunteers her time and excellent artistic talent to paint a healthcare story, you sign a contract to wear this jacket when you go to conferences. When wearing, attendees will notice the picture on the back of your jacket, an unconventional place to find art, and will ask about its meaning. Wherever you wear it, you naturally can share your healthcare story, and you become part of the gallery to showcase your work, hence the name of ”Walking gallery of healthcare.” The conversation can inspire the other person to think about the healthcare story more in the jacket’s wearer's story. After I received my jacket from her, I loved the idea and her work so much, I took a step further to paint my own, which any of you can do if you wish. (Or you can ask any of the artists to paint one, including me.)
What would it be like to have zero harm in healthcare? I would feel heard and safe to speak up as a patient or a caregiver, and I would feel the same even when mistakes happen as a healthcare professional. The intention to do no harm is honored by all parties, and trust and honesty are at the heart of healthcare, so all of us feel safe when we are looking for healing.
The first step to getting there?
Accept that we are all humans.
Accept that we are all patients at some point in our lives.
Accept that we all can make mistakes.
Accept that we can all do something by dreaming together that zero harm is possible; the more we dream together, the closer we will be to zero harm in healthcare.
If Covid-19 has brought anything together for literally all of us from all over the world is the realization of the need to feel safe. I feel all of you can agree with me to some degree. Healthcare is local and global this way.
That is why I cannot let go of this opportunity to ask you to dream with me: zero harm in healthcare.
Institute of Medicine. 2000. To Err Is Human: Building a Safer Health System. Washington, DC: The National Academies Press.
Regina Holliday’s Walking Gallery of Healthcare: https://www.facebook.com/TheWalkingGalleryHC/
(Please email me at email@example.com, if you are interested in sharing your story through art with Regina and other artists.)