Monday, May 30, 2011

Liar, Liar

Even as the best writers are careful not to come off as having an agenda, there is always a theme, unstated, something to wonder about, that comes through character, plot, and setting of a well-told story. Not surprising, the theme in the novel Liar, Liar, by Gary Paulsen, deals with the value of honesty, but not only that, it's also about the importance of apology.

As we see in Liar, Liar, even if apology is the right thing to do, it is hard to look at someone you've hurt and admit you have done something wrong, made a mistake.

Kevin Spencer, the protagonist in this middle grade novel, is fourteen. He sets out to manipulate his best friend, to dump schoolwork on a classmate, and to shirk other responsibilities, by lying. Paulsen has made Kevin a comic character with a fixed belief that lying is good. He loves bending circumstances to get what he wants.

But, at the climax, his world implodes. Everyone is mad at him. How does he make things right? Through apology, a term that Kevin defines for us.

He tells us: “I was going to have to admit to everyone what I’d done, take responsibility for my actions, express regret for the pain I’ve caused, accept the consequences of my behavior, make sure they knew I was serious about making it up to them and then never act like that again. The perfect apology.”

This book is relevant to health care where tens of thousands of mistakes are made every year and where the pros and cons of apology are still debated. Is the art of apology only for children?

Should doctors and hospital administrators admit, (or disclose) error, apologize to injured patients and work to prevent future error? Some say it's the only way to have a safe health care system.

But others avoid admitting error, or reporting errors, convinced that doing so encourages lawsuits.

The best hospitals, such as Johns Hopkins Hospital have embraced disclosure of errors and apology. For those in the medical profession still on the fence about this issue, Psychiatrist Dr. Aaron Lazare's wonderful book On Apology is well worth reading, as is The Best Practice, by Charles Kenney. The book Josie's Story  by Sorrel King tells the courageous tale of a mother who sought the truth after her toddler dies in a hospital of a medical error. Through persistence, she uncovered and changed unsafe medical and nursing practices. She changed the culture of an entire hospital. An apology from the chief of pediatrics helped her to heal. emotionally. 

As children learn from Gary Paulen's protagonist, Kevin Spencer, that apology is the right thing to do, their parents might see, as well, the relevance beyond childhood. 

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