Gabby_ A Story of Courage and Hope - Alison Hanson [93]
I was not going to tell her, “Sorry, honey, that didn’t occur to me.”
So I let Dr. Rhee know that the second opinions were going to happen with or without his help. I told him I’d been speaking to Admiral Mike Mullen, chairman of the Joint Chiefs of Staff, about this very issue. As the senior officer in the military, and a Navy admiral, he was essentially my boss. Dr. Rhee is a retired Navy surgeon, so Admiral Mullen used to be his boss, too. My request to Dr. Rhee finally sank in.
Several hours later, he stopped me in the ICU corridor and said, “I have Geoffrey Ling and Jim Ecklund from Walter Reed on their way here. These guys literally wrote the book on penetrating head injuries and both had experience treating soldiers in Iraq and Afghanistan. Are you happy now?”
“Yes,” I told him, and I was.
When Drs. Ecklund and Ling arrived, they spent time reviewing the many CAT scans and pages of medical records, and conferring with Gabby’s Tucson doctors. They felt that Gabby had received excellent care from Dr. Lemole, Dr. Rhee, and their teams. They did make recommendations to change some of Gabby’s treatment in the ICU. Their advice, and their analysis of the good work being done by the medical teams in Tucson, was very reassuring to me. But there were still a great many medical decisions ahead.
Gabby needed an additional operation to rebuild the upper half of her fractured right eye socket. (Although the gunshot was to the left side of her head, the force of the bullet fractured both orbits. The right side was in worse shape and required additional surgery.) After speaking with Dr. Rhee again about my desire to have second opinions, he invited two Navy ophthalmologists that he knew from San Diego to fly in and examine Gabby. Once they arrived, I asked if I could get them together with the Tucson doctors and residents for a short meeting.
There were eight or nine of us in the room, and the doctors were discussing whether to do the surgery from inside Gabby’s eye socket or to do it by cutting through her skull above the eyebrow. I decided to take a moment to tell them what I had learned at NASA about decision-making. I explained that phrase posted on the wall of the conference room used by the Mission Management Team during space shuttle flights: “None of us is as dumb as all of us.”
“It means,” I said, “that when you get a group of people together to make a critical decision, groupthink can set in. There’s all this technical information, a critical decision needs to be made, and everyone starts marching in the same direction. There might be some people who think it’s the wrong direction, but they don’t say anything. They just remain a part of the group.
“At NASA, we’ve learned that groups can make stupid decisions that no single individual in the group would make. We had a couple of terrible space shuttle accidents—Challenger, Columbia—and when we looked back in hindsight, they may have been preventable. There were individuals who had the right information, or in the case of Columbia, had seen the issue before. If people spoke up, perhaps those catastrophes could have been avoided.”
I looked around the hospital meeting room. I was searching for the youngest, most inexperienced person, and settled on an ophthalmology resident sitting in the back. She looked to be in her late twenties. I pointed at her. “So yesterday, the plan was to go through the eye socket to approach the fractured area from underneath,” I said. “Now, today, everyone is saying that it’s better to go through Gabby’s forehead and make the repair from above. You’ve been listening to the whole discussion. I need to know if you think this is the correct approach.”
She seemed a little nervous. She