How to Protect Yourself From Medical Mistakes (Even When Hospitals Already Feel Scary)
A conversation with Dr. Gerardo Garza, critical care physician, pulmonologist, and author of The Patient Survival Guide: How to Avoid Medical Mistakes
If you have ever sat in a waiting room with your heart pounding, or put off a scan for months because the thought of walking back through those doors made you feel sick, this episode is for you.
A lot of people search for help with health anxiety long before they ever hear the phrase medical trauma. They know the fear is there. They know it spikes around appointments, scans, hospitals, and phone calls from unknown numbers. What they often do not know is that the fear is not irrational, and it is not a character flaw. It is a nervous system doing exactly what it was built to do after something frightening happened inside a medical setting.
This week on the Medical Trauma Support Podcast, I talked with Dr. Gerardo Garza, a pulmonologist and critical care physician who has spent more than fifteen years working in the ICU. He wrote The Patient Survival Guide: How to Avoid Medical Mistakes as a plain-language handbook you can carry with you into an appointment or a hospital stay.
Something I noticed during this conversation is the overlap between his patient safety work and the work I do with medical trauma. He talks a lot about preparation and I do too, but we come at it from different directions. This makes sense as he is an MD and I am a therapist. I’m coming at it from a mental health place and focus on how to support yourself emotionally while he is focused on the physical safety aspect.
Are medical mistakes really one of the leading causes of death?
Dr. Garza cites the figure most often quoted in the research: more than 200,000 deaths a year in the United States linked to medical error. Researchers disagree about the exact number and the estimates vary widely, but the scale of the problem is not in dispute.
He is also clear that things are improving. Hospitals and health systems have built out protocols and safety guidelines, and the issue gets far more attention now than it did when he was in medical school. His frustration is with the preventable cases, the ones where a single question or a second look would have changed everything.
Why do medical mistakes happen?
Dr. Garza shares that he believes nearly every healthcare worker has your best interest at heart. When mistakes happen, they usually are not the result of one careless person. They come from a complex system with many moving parts, staffing shortages, exhausted clinicians, technical failures, and gaps where information falls through the cracks.
The biggest single factor he named was communication.
I have talked on this podcast many times about what happens to providers inside systems that do not care for them well. Compassion fatigue, burnout, and moral injury are real, and a clinician who is physiologically depleted has less capacity for the kind of collaborative, unhurried conversation that keeps patients safe. Dr. Garza saw this firsthand in the ICU during COVID. Understanding that does not excuse harm, but it does explain a great deal, and for many patients it loosens the grip of "something about me made them treat me that way."
What is the best protection against medical mistakes?
Dr. Garza's answer, in his own words: your best protection is being well informed and engaged, and your most effective safety tool is communication.
That means asking questions when you do not understand something, and speaking up when something does not seem right. He addressed the fear directly, because he hears it from patients all the time: the worry that asking questions will make you look distrustful or difficult. A good physician, he said, welcomes that engagement.
How do you prepare for an appointment when your body already feels unsafe?
Here is where his patient safety advice and nervous system work meet.
When you feel threatened, blood flow shifts away from the prefrontal cortex, the part of your brain that holds your questions, your timeline, and your ability to advocate for yourself. This is why so many people walk out of an appointment and only then remember the thing they came in to say. You are not scattered. Your body prioritized survival over recall.
So you plan for it in advance.
Write your questions down before you go. Dr. Garza recommends this for every patient. Write the reason you came, and the things you want addressed before you leave, so the visit does not end with your actual concern untouched.
Keep a current medication list. Include over-the-counter medications, supplements, and herbs. Ashwagandha, for example, is something a lot of people take for stress and never think to mention. Interactions are a real and preventable source of harm, and many people arrive at appointments genuinely unsure what they are taking.
Bring someone with you. Dr. Garza calls this a healthcare advocate. Choose someone whose presence actually settles you, and who will keep asking questions if you go quiet or shut down. This matters especially in the visits where you might receive difficult news.
Add a second page for your nervous system. This is the piece I always add. Alongside your questions, write down the coping strategies that work for you, so you do not have to retrieve them under stress. Mine says things like straw breath, sternum tapping, and move your body when you can. Having it in front of you means you do not have to think of it, you just have to read it.
Is it okay to switch doctors if you do not feel safe with one?
Yes. Both of us landed hard on this.
I used to talk about this constantly when I worked as a doula, watching an enormous range of provider styles play out in delivery rooms. Dr. Garza says the same thing to his own patients: it is about fit and communication style, and nobody (who is emotionally healthy) will blame you for seeking a second opinion or moving on. Not every mismatch means a clinician is bad at their job. It may simply mean they are not the right fit for you.
If you are trying to participate in your own care and you keep running into irritation or a closed door, that is useful information.
Why is hospital discharge such a risky moment?
Discharge is a critical transition, and Dr. Garza flagged it as a common point of failure. It is when medication reconciliation happens, when prescriptions get sorted, and when instructions get delivered, sometimes quickly, sometimes to someone who is still foggy and overwhelmed. Then you are home and on your own.
Ask for clarification before you leave. Make sure you understand the medication changes and that your follow-up is actually scheduled.
I raised one more thing I would love to see change: discharge paperwork often does not include mental health resources. Patients leave with wound care instructions and a follow-up appointment, and nothing at all for what just happened to them psychologically. Dr. Garza agreed immediately. A small slot on that form could change the trajectory of someone's recovery.
What is post-intensive care syndrome (PICS)?
Post-intensive care syndrome, or PICS, refers to the physical, cognitive, and emotional effects that persist after critical illness, well beyond the original medical problem.
Dr. Garza sees it in his pulmonary clinic, and he saw it most during COVID. He described patients who will not go back to a hospital under any circumstances, no matter what. His response to that was not to argue with them. It was to say he does not blame them.
He also named what these patients need: honoring and validating their experience. If you are familiar with my work at all, you know that his comment here gets to the heart of what I believe, we all deserve to be honored and validated. Our experiences matter!
The part clinicians should really hear
When I talk with people about their traumatic medical experiences, what was most traumatic to them is frequently not the medical event itself. It is how they were treated while it was happening.
Which means the reverse is also true, and it is much simpler than most clinicians think. "That sounds really hard." "I can understand why you would not want to come back." Those sentences are not filler. They are the difference between a patient who believes they can never walk into a system again, and one who walks out thinking, that was hard, and I was treated like a human being.
This is the heart of the LAVS framework I teach: Listen, Acknowledge, Validate, Shift. The listening comes first, and validation is not a soft add-on to good clinical care. It is part of it. Dr. Garza got there on his own, from inside the ICU, which tells me it is not a just social work idea. It is a care idea.
Dr. Garza's message for you
I asked him what he most wanted listeners to walk away with:
"Your best protection against medical mistakes is being well informed and engaged, and your most effective safety tool is communication. Always ask questions if you do not understand something, speak up, get informed, and stay safe."
Before your next appointment
If reading this brought up that familiar tightening, and the idea of writing questions down sounds reasonable but you have no idea how to do it without spiraling, start there.
Navigating Medical Appointments with Your Nervous System is a somatic guide that walks you through preparing for an appointment when your body already registers that room as dangerous. It covers what to write down, what to do in the waiting room, and how to come back to yourself afterward. It is $11 and you can use it the same week.
If you want ongoing support rather than a one-time resource, the Medical Trauma Support Circle is our peer community for people navigating medical trauma, with a live group each week and a place to be believed. Membership is $39 a month.
And if you are a clinician who wants to be the provider your patients remember for the right reasons, Join my mailing list (and get a free guides while you’re at it), I will be releasing my CE course for practitioners later this summer!
Frequently asked questions
What is medical trauma? Medical trauma is a psychological and physiological response to a distressing medical event, diagnosis, procedure, or interaction with the healthcare system. It can develop from a life-threatening illness, but it can also develop from being dismissed, restrained, unheard, or frightened during care. Learn more on our What Is Medical Trauma page.
How do I prepare for a doctor's appointment if I have medical anxiety? Write your questions and concerns down before the visit, bring an updated list of all medications and supplements, bring a support person if you can, and keep a written list of your coping strategies where you can see it. Under stress, your brain has limited access to recall and planning, so the goal is to prepare in advance rather than rely on memory in the moment.
Can I change doctors if I do not feel comfortable with mine? Yes. You can change providers or seek a second opinion at any time, and it is a normal part of finding the right fit. Communication style is a real component of patient safety, not a preference.
What is post-intensive care syndrome? PICS is the set of physical, cognitive, and mental health effects that can persist after a stay in the intensive care unit, including PTSD symptoms, memory and concentration difficulties, weakness, and avoidance of medical settings. It can last long after the original illness has resolved. Check out our PICS resource page.
Are medical errors the third leading cause of death in the US? Some widely cited research places medical error among the leading causes of death in the United States, with estimates above 200,000 deaths per year. The methodology behind those figures is debated among researchers, and estimates vary considerably, but preventable harm remains a significant patient safety problem.
Listen to the full episode on YouTube.
About the guest: Dr. Gerardo Garza is a board-certified pulmonologist and critical care physician with more than fifteen years of ICU experience. His book The Patient Survival Guide: How to Avoid Medical Mistakes is available on Amazon in paperback and Kindle. He shares patient safety tips on Instagram - https://www.instagram.com/drggarza/
Related listening: Vanessa's episode, recorded with the ICU physician who cared for her.
Related: Walk4PICS, September 26, 2026.