Of all the interview stations I had for medicine, I remember one very clearly. I was asked to pick out three traits that I believed would make a good doctor. I remember choosing cards on teamwork, courage, and resilience, proudly explaining each choice accordingly to the examiner.

The examiner then picked out a card I hadn’t chosen – and put it down in front of me. She asked me to explain why I hadn’t included that particular card in my original choice.

Panicking, I looked down at the card, which read “swift decision making”. My first thought, was that I had made a mistake, and performed the unexpected by not choosing that card. However, very swiftly, I thought of a genuine response; I told the examiner that whilst decision-making skills are crucial in medicine, not all swift decisions are right decisions.

I have thought about that comment a lot throughout the past few years of medical school, and silently debated whether I still stand by that comment. From the outside, medicine seems to respect conservation of time; this is shown by the merit placed upon rapid fire questioning of students by many doctors, and indeed the rapid life-or-death procedures that are performed in the resuscitation bay to save the lives of acutely unwell people.

This past week, I had the opportunity to discuss a scenario which showed me why quick decisions don’t always lead to the best outcomes. This was the scenario:

A paediatric consultant received a phone call to say that there had been an error in the prescribing of a medication, and whilst the child was okay, he had to explain the situation to the child’s parents. 

The child had become acutely unwell, and one of the junior doctors had prescribed medication to help alleviate the symptoms. However, in haste, the incorrect dose was requested. The junior doctor apologised to the parents, and along with the consultant, explained how the mistake had occurred. Thankfully, the error was not life-threatening; all that was needed was extra monitoring of the child.

Discussing this scenario made me realise the impact that mistakes can have on patients and their families. For this family, the price would be a sleepless night. For others, it could be more than that. Thinking about it had a great impact on me; I put myself in the junior doctor’s shoes – I thought about how I would feel if the scenario was real and the mistake was mine.

I must admit that at times, I would find myself envious of my peers and mentors for their speed and efficiency – I don’t seem to be as gifted in the art of rapid-fire questions. I always believed that this would also be a reflection on my ability to handle stressful, acute situations, however I seem to work well under pressure, and I find myself most enjoying busy assessment unit placements. I thought about this also – how can I be good in one situation and not the other?

The answer, I believe, lies in the difference between making a decision in haste, and making a decision promptly. These may sound similar, but the distinction lies in the extra 10 seconds it takes to consider the further outcome of your decision. Sometimes, you may stop to think, and realise that your first decision was correct. However, there may be a time that those extra 10 seconds help you realise you are making a mistake. The delay may be priceless, particularly for your patient.

I think that I am now more comfortable with the fact that I spend an extra 10 seconds thinking about things, even though it means that I appear to be less “sharp” than some of my peers. I am also hoping that with experience, 10 seconds becomes 5 seconds, then 3 seconds, and so on, until the pause is no longer noticeable. I have a feeling it will always be there though, acting like a safety net for a fallible mind.

If a momentary pause means coming up with a better answer, or solution to a problem, then I’m never going to regret it. After all, the first decision isn’t always the best decision, is it?