Medical Harm: A Brief Personal Lens

How one experience with diagnostic delay shaped my work in healthcare, advocacy, and legal nurse consulting.

I have worked as a Legal Nurse Consultant since 2006, and throughout that work I have reviewed healthcare experiences involving adverse events, diagnostic concerns, communication failures, professional practice issues, and medical harm.

But my understanding of medical harm isn't only professional.

It's personal.

Looking Beyond the Outcome

Medical harm is complex. An unexpected or poor outcome does not automatically mean that negligence occurred, nor does every diagnostic delay mean that a different outcome would have been possible.

What these experiences do require is careful examination.

What information was available at the time?What symptoms were present?What clinical decisions were made?Were appropriate standards and processes followed?Were there opportunities for further assessment or follow-up?And what happened to the patient and family as a result?

Diagnostic error is one area where these questions become particularly important. Missed, delayed, or incorrect diagnoses can postpone treatment and contribute to physical and psychological harm.

Common contributors may include:

• incomplete or inaccurate patient information

• difficulty interpreting diagnostic findings

• failure to recognize an evolving disease process

• symptoms being overlooked or attributed to another condition

• cognitive bias

• communication or follow-up failures

• system-level gaps in assessment or care coordination
  

Those concepts became very real to me long before they became part of my professional lens.

When the Case Becomes Your Family

In 2008, my husband, Shannon, experienced what our family would come to understand as a delayed cancer diagnosis.

He was 33 years old.

After two emergency department encounters for significant gastrointestinal symptoms, his presentation was initially attributed to less serious causes. He was young, active, working, and seemingly an unlikely candidate for advanced colorectal cancer.

But something was wrong.

Two weeks later, further evaluation revealed Stage IV colon cancer with liver metastases.

Shannon died 19 months later.

I cannot say that identifying his cancer during that initial encounter would have changed his ultimate outcome. His disease was already advanced, and retrospective certainty is something healthcare rarely affords us.

What I can say is that delayed recognition changed our experience of his illness.

There was physical suffering. There was psychological distress. There were unanswered questions. And there was the realization that patients who don't fit the expected picture of a disease can be particularly vulnerable to having serious symptoms attributed to something less concerning.

That experience changed the way I looked at healthcare.

From Personal Experience to Professional Purpose

As a nurse, I began asking different questions.

How do clinicians recognize the patient who doesn't fit the textbook presentation?

How do healthcare systems create safeguards against cognitive bias?

What happens when patients or families continue to say, something isn't right?

And when harm occurs, how do we examine it fairly—not simply to assign blame, but to understand what happened and determine what should happen next?

My experience with Shannon became one of the influences behind my growing interest in health policy, patient advocacy, diagnostic safety, medical trauma, and legal nurse consulting.

It also led me into colorectal cancer advocacy, including serving as a Colon Cancer Alliance Ambassador and participating in advocacy efforts on Capitol Hill.

The loss was personal.

The questions it created became professional.

The Medical Harm Lens

Today, I think of this as viewing healthcare through a medical harm lens.

That lens looks beyond a single outcome or decision.

It considers the clinical picture, documentation, professional standards, communication, systems, ethics, patient experience, and human consequences surrounding an event.

My background now spans psychiatric practice, legal nurse consulting, healthcare education, leadership, and forensic healthcare. Those roles may appear different, but they repeatedly bring me back to the same questions:

What happened?

Why did it happen?

What standards and systems were involved?

Who was affected?

And what can we learn from it?

Medical harm deserves thoughtful examination because patient safety and professional accountability are not opposing goals. Healthcare professionals deserve fair, evidence-based evaluation, and patients and families deserve systems willing to examine harm honestly when it occurs.

For me, this work will always carry a personal dimension.

Shannon's illness changed our family forever. It also changed the nurse I became and the way I understand advocacy, healthcare systems, and justice.

Nearly two decades into my work as a Legal Nurse Consultant, I continue to believe that some of the most meaningful improvements in healthcare begin when we are willing to examine difficult experiences with clinical rigor, compassion, accountability, and curiosity.

Nourish what matters. Protect what is vulnerable.Navigate complexity. Pave the way forward.

In memory of Shannon Hamilton, 1975–2010.

— Dr. Nikol Hamilton, DNP, APRN, PMHNP-BC, LNC

2009 Crawling through the Inflatable Colon 2010 Last pics with Carson and her dad Freedom or Fear ? You must choose to deal with genetic risks and test don't guess! Faith is truly the only thing that helped get through every trauma with decisions that were made and the disruptive truths of family medical catastrophe.

Catastrophic illness support is needed for those who also have dealt with medical trauma. This began a health policy and advocacy career shift in my nursing aptitude and became a Colon Cancer Alliance Ambassador to Call on Congress! (more on that but the poster is in my office from Times Square and Capital Hill )

     RIP: Shannon Hamilton 01/29/1975 -07/05/2010

--Nurse Nikol

Reference

Wilson, D. M. M. (2024, November 29). The Dangers of Medical Misdiagnosis. Retrieved January 29, 2025, from https://wilsonlaw.com/blog/the-dangers-of-medical-misdiagnosis/

Smith, K., Baker, K., Haskell, H., Hill, M., & Tate, J. (2021). Using Patient Experience Surveys to Assess Diagnostic Safety in Urgent Care. Health Services Research, 56(Suppl 2), 53–54. https://doi.org/10.1111/1475-6773.13822