The opening of Dr. Stanley M. Berry's debut novel, A Fight For Full Disclosure, draws readers into the surgery room of Winslow Medical Center in Detroit, where Dr. Warren Chambers is engaged in a laparoscopic hysterectomy procedure

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The patient, Carla Williams, is a high school teacher, mother of three young children. Dr. Chambers is an accomplished surgeon and has been taking care of Carla for roughly twelve years.

What was thought to be a routine operation turns out to be a tragedy, as something goes awry during surgery and Carla dies. Dr. Chambers can't figure out the cause of Carla's death and blames himself, leaving him in a state of shock and depression.

The narrative shifts to the hospital's waiting area, where Dr. Chambers tells Carla's mom, Sylvia, that her daughter died because of internal bleeding. He informs her he and his team tried everything to save Carla, but to no avail. Carla's death was unexpected and the

Medical Examiner will insist on an autopsy.

When Dr. Harold Thompson, Chair of the Obstetrics and Gynecology Dept, gets wind of the tragedy, he telephones Dr. Chambers, who discloses what transpired. Dr. Thompson consoles Dr. Chambers and tells him to hang in there.

Much of the conversation swirling around the hospital was OB/GYns' surgical ineptitude and their constant need for general surgeons to bail them out. Dr. Chambers' competence is questioned. The role of the Anesthesia group was not examined.

Dr. Thompson is approached by Henry Davidson, Winslow's Chief Safety Officer. Davidson's task was to conduct root cause analyses on all negative occurrences he deemed to be "Sentinel Events." These are any unanticipated or unusual events in a medical setting that results in death or serious physical injury to a person or persons.

The Manual Guidelines published by the American Board of Hospital Accreditation refer to these events as "Sentinel" because they signal the need for immediate investigation and response.

A committee is set up by Dr. Thompson, who agrees not to serve on it but appoints two people.

Davidson was not well-liked at the hospital. There was a widespread suspicion that he and his committees were not in pursuit of truth. Instead, they sought to affix blame.

There was also a feeling that he usually steered his committees to their usual conclusion that mishaps they examined were due to "human factors."

Out of their sense of empathy and compelling duty, Drs. Thomson and Chambers agree they must show up at Carla's funeral, pay their respects, and contact Carla's family. Something that is generally frowned upon by the hospital administration.

At the funeral chapel, Dr. Thompson meets Carla's auntie, Janis Mae Sipple, and tells her he would like to meet with Carla's mother when it is suitable for her to review what happened to her daughter.

Dr. Thompson gets together with Sylvia and her sister Janis in his office. The notion that perhaps he shouldn't have met with them crosses his mind, but he shoves it away and ignores it. He realizes fully that his actions were not the norm, especially at his hospital.

The sisters are notified that there will be an inquiry to find out what precisely happened to Carla. Dr. Thompson mentions that when it is completed, he assures them he will discuss the results and explain to them what transpired.

He also imparts to them that if something the doctors did was amiss, he would do all in his power to make sure that they get financial support.

It never dawns on him he ultimately would run into a great deal of hot water with the administration for meeting with the sisters and promising to give them full disclosure.

Dr. Thompson feels strongly about making a "full disclosure," which puts him at odds with many of his colleagues and Davidson.

He feels that patients and their families should be told when matters go awry. It's their right to know about it. It was a different approach in hospital-patient relations.

Full disclosure was embraced by most professional associations as part of the safety culture. Still, it was far from universal acceptance in the healthcare industry.

Dr. Thompson, through his efforts, eventually is the subject of an arduous investigation by some of the hospital staff because it is believed that he had planted the seed with Carla's family that mistakes were committed.

There is the fear that the hospital would lose its accreditation and be subjected to costly litigation. Quite a turn of circumstances, when you consider that initially, the attention was on Dr. Chambers.

Despite some first novel tics, such as inserting immaterial scenes that slow down the story's pace, the novel is an extraordinarily believable depiction of what takes place in a hospital's operating room when something goes wrong.

The reader turns pages compulsively because of its ease in envisioning what is transpiring. It is also packed with articulate realistic dialogue that reading resembles watching a movie. The medical explanations are well-blended into the novel, adding to the richness of the fiction.

Dr. Berry raises many questions as to disclosure and there is much to ponder here. Thankfully, attitudes have changed in recent years. Today, many physicians disclose a grave error to their patients and agree that such disclosure is warranted. This is in contrast to the past where patients harmed by a medical error never learned of the error. Physicians had been afraid of discussing mistakes with their patients, partly due to possible litigation and partly due to embarrassment and discomfort.

Follow Here To Read Norm's Interview With Dr. Stanley M. Berry