Patient Safety - Reality Check

Dr. Federico Castro-Moure

Abusive drunk physician tries to operate

Dr. Federico Castro-Moure, chief neurosurgeon at Highland Hospital in Oakland, California, is included here for having said, “Do you know that I am a (expletive) doctor, and I’m going to do what I want” according the The Oakland Tribune. Doctors too routinely are allowed to do what they want without anyone stopping them or reporting them or doing anything but defending them. That they are used to having that much power and protection surfaces from time to time in statements like that and the behavior of others on this list of examples.

No group of human beings can be trusted blindly with that much power. It leads even to the commissions of crimes against helpless patients. Crimes are the tip of the iceberg - a revealing tip that we are kept from seeing. In this case, he wasn't committing a crime. Driving while drunk is a crime, but operating while drunk is not. They did not call the police because he was drunk. Normally inebriated surgeons are not discouraged from operating. They don't call the police to protect patients from possibly being injured by an inebriated surgeon. These staff didn't call the police until they worried he was going to hurt a nurse. Sometimes they will protect their own.

Sometimes they won't
(See Loyalty or Mobbing)

In the newspaper it said that Dr. Casto-Moure was on call when there arrived a patient who had fallen two stories and landed on his feet. Casto-Moure wanted to operate immediately but was told the instruments would have to be sterilized first. He threw fit, yelling and swearing at staff, telling them "he didn't (expletive) care what hospital procedure was." The charge nurse refused to admit the patient into the operating room until the instruments were re-sterilized. Casto-Moure began punching his fist into his hand while walking toward the nurse. Sheriff deputies at the hospital were called. When they arrived Castro-Moure screamed at them, "What the (expletive) do you want? . . I am a (expletive) doctor, and I'm going to do what I want."

They tried to calm him down, but he shoved one officer and took a swing at another. Deputies wrestled him to the ground, handcuffed him and put him under arrest.

If he hadn't threatened a nurse, hospital staff normally would have allowed him to operate and, even if the patient ended up with life-ruining injuries, no one ever would have found out that the surgeon had been drunk. They don't make records of things like that in medicine.

But he struggled with the police

So it made the news. Has the doctor ever operated while under the influence before? How would anyone know? Who would tell?

We need for patients, if no one else, not just to be allowed to report what happens to them in medicine, but to see that they have a duty to do that to protect other patients. We need a mechanism set up that encourages their reporting, and that encourages hospital staff and others to report as well. State patients boards could do that if they existed. At least they could provide a single phone number for all complaints about healthcare so people at least would know a number to call. The way things are now hospital staff wait for things to reach a level that requires the intervention of the police to protect other staff members. If there were one phone number everyone knew to call, perhaps they would call a bit sooner.

But, of course, the way things are now, people who report problems in medicine can be sued or fired or blacklisted for having done so. We need state patients boards to try to arrange for them to be able to report without that happening.