Patients need to keep up their end of the deal
A Medical Perspective
Sometimes doctors get very frustrated when patients don't seem to get it. Take the overweight man with heart problems who will continue to decline in health until he loses weight and lowers his cholesterol but he never listens. Take the drug addict who shows up in the Emergency Room at least twice a week who will not kick the habit unless he gets put away and into a treatment program. And the list goes on…
In each case the doctor provides compassionate medical care, often without passing judgment on the patient. Do you know how hard that is sometimes? Sometimes I've come very close to shaking my patients and saying "What the heck were you thinking for ______" (fill in the blank), but I don't. It's not the doctor's place to do things like that, even if he wants to do so.
I was working in the Emergency Room one day and a nurse asked me to do a 12 lead EKG, a job which I perform about a dozen times during a typical eight hour shift. As I wheeled the machine into the room, I see a man in his early 30's talking to his young daughter. "It'll be OK sweetie. Go outside with my friend while daddy gets checked out." The daughter hugs her dad and then leaves.
The man is visibly anxious but otherwise looks fine. I usually get to talking to the patient while I'm attaching the electrodes to their chest to put them at ease but I don't have to for this one. Before I can say anything he starts talking.
"Man, I really messed up. I smoked a whole bowl of coke yesterday and now my heart is racing. I can't let my ex-wife find out or else she'll take away my daughter. What will happen?" he asks.
"Uh…I don't know. I'm sure you'll figure something out." I said, stumbling over my words. I continue setting up the machine and I run the EKG in silence.
In my mind I'm thinking, "What the heck are you thinking, doing drugs with a child in your house! Of course they should take your daughter away from you! Are you stupid or something? What if she finds daddy's cocaine stash and has some! Ever thought of that?! What if you shoot up one day and daddy ends up dead of a drug overdose, what will your daughter think then?" I envision myself shaking him up and down to drive home my point.
When you choose to mess up your own life then what you do is your own business. When you endanger the life or future well-being of a child it really gets to me. Of course I did not carry out what I was thinking but sometimes I think I should have. Yet I did my job- providing quality medical care without passing judgment or telling him what I really thought.
What doctors often find is that you don't get to pick and choose the patients and problems you deal with. You learn that you will have to keep yourself from passing judgment on your patients or trying to unfairly coerce them into doing what you think is the right thing, even if it is in the patient's best interest.
As far as the case I mentioned I never did find out what happened to the man or his daughter since my shift ended soon after that. That's the way it is in the Emergency Room; you often can't follow your patient's care all the way to discharge. Standard procedure would have involved notifying social services but anything can happen from there. I can only hope that the daughter ended up okay and is not living with her father. Sometimes that is all you can do: hope.
Steve Carroll is a sophomore biology major. He is certified as an Emergency Medical Technician and a firefighter in Pennsylvania. His future plans include going to medical school and becoming an Emergency Room doctor or a trauma surgeon. He can be reached at email@example.com.
The views expressed in this column are those of the author and not necessarily those of The Observer.
All Viewpoint Stories for Friday, October 12, 2001