Anupam Jena speaking at the TEDMED 2020 conference. Image: TEDMED 2020
Speaking at TEDMED 2020 on March 2, Anupam Jena, the Ruth L. Newhouse Associate Professor of Health Care Policy in the Blavatnik Institute at Harvard Medical School opened his talk by referencing the 2013 Boston Marathon bombing in which three people were killed and more than 200 were injured.
The true casualty numbers, however, may have been underreported, Jena said, because, although they were in plain sight, medical professionals were not trained to see them.
Citing a paper he published in 2017, Jena said when big cities close roads during marathons, the number of elderly Americans who die from cardiac arrest increases by 15 percent. Ambulance transport times are longer on marathon mornings, but these delays disappear when roads reopen in the afternoon. Because of this, Jena said, more people likely died from ambulance delays during the 2013 Boston Marathon than during the actual bombing.
“We sometimes look important facts right in the face, and we miss them completely, because we aren’t trained to ask the right questions,” Jena said, adding that critical information can be missed in health care because events occur not in a study environment but rather as natural experiments in the everyday world.
“Being a casual observer is not the same thing as being a thoughtful observer and analyzing what you see,” Jena said. “And as a result, I think that we are at risk for overlooking important facts in many health care environments, because for the most part, we are not trained to think in larger, creative terms. We are not conditioned to be on the hunt for these anomalies and to interpret what they mean.”