Published on 14 May 2026

Recently I saw a 60-year-old patient with symptoms and signs suggestive of cardiac failure. She told me that at the age of 40 she had been diagnosed with “a leaking heart valve.” On examination she had a prominent cardiac murmur. I arranged assessment by a physician at our regional hospital, requested an echocardiogram, and started anti-failure treatment.

Two weeks later she returned. Her breathlessness had improved, but she now complained that she had developed a craving for eating sand. Her haemoglobin was found to be very low, with severe iron deficiency anaemia. She was referred to our district hospital for blood transfusion and iron infusion, and we are now investigating the cause of the anaemia further.

Reflecting afterwards, I realised how quickly I had anchored onto her valvular heart disease as the explanation for her presentation. The history and examination findings fitted so neatly that I did not initially give enough weight to other possible contributors — including severe anaemia as a precipitating cause of heart failure.

In my own experience, and in conversations with colleagues, I find that many mistakes arise not from lack of knowledge or lack of caring, but from narrowing our thinking too early around what seems to be the “obvious” diagnosis.

During my training and early years of practice, mistakes were often viewed as something that simply should not happen. If you made one, it meant you were a bad doctor. Over time I have come to realise that medicine is practiced in uncertainty, and that mistakes and blind spots are inevitable parts of being human.

That awareness brings vulnerability, but perhaps it also brings humility. And maybe humility — remaining aware that we could be wrong — helps us listen more carefully, think more broadly, and ultimately make fewer mistakes.

In my coaching work with doctors, I often see how perfectionism and fear of mistakes quietly contribute to stress, self-doubt and burnout. We need spaces where doctors can reflect on mistakes and uncertainty without shame.