My Doctor Reading List

Monday, July 23, 2012

Shameful


My grandmother is in her early 80's and has really declined in health over the past couple of years. Her health  has never been great (largely due to her very sedentary life-style combined with a smoking addiction) and as she aged and moved less, took more pain killers and continued to smoke, got worse. Recently she developed some nasty bedsores and my mother (who is her daughter-in-law) was so shocked when she saw them, she immediately rushed my grandmother to her family doctor. 


My mother told me that what happened next, and over the next few days, has left her livid and speechless with disappointment.

At the visit to the family doctor, she said that when the doctor came in, instead of greeting her and my grandmother, he asked "Why on earth isn't she in a nursing home?" My mother, totally caught off guard, didn't even have time to answer that my grandmother is wealthy enough to afford two full-time caretakers to care for and help her in her own, comfortable home and did not WANT to be in a nursing home, a decision that her children (my dad and aunt) respected. The doctor just marched over to my grandmother, and with a totally disgusted look on his face, gingerly lifted the edge of the bandage covering the bedsore, glanced at it for a second and dropped it. He told her there is nothing he can do and she should take my grandmother to the ER - but then added "Though I don't know why you'd bother...they usually die a few months after developing them anyway." My mother told me she was horrified, that firstly he grouped my grandmother into this group of "they" - meaning the elderly (who for some reason don't deserve to have treatment) and to do so in front of my grandmother!

My mom didn't want to drag my grandmother to the ER (knowing what the wait times in Ontario ERs are like and didn't want to subject my grandmother to that unless absolutely necessary) just because the doctor clearly just couldn't be bothered with her, she took my grandmother to a walk-in clinic to get a second opinion. She said this doctor, was much nicer, examined my grandmother and prescribed an antibiotic.

However, after two days my mother thought that the sores looked worse, so she decided she would take my grandmother to the hospital and called an ambulance (because doing so cuts down on the waiting time a little).

What happened at the hospital she said furthered her anger. My grandmother was left on the stretcher for hours and no one would come to check on her. She said when she finally was given a "room" (i.e. a bed with a curtains on both sides for privacy) she again waited for hours until the doctor would come. Finally she said a young doctor entered and she was relieved. She said she went over to my grandmother to help turn her over, and was surprised the doctor didn't budge to help her. Without introducing himself, acknowledging my mother or my grandmother, grabbed a swab and, just like the first doctor, lifted the bandage, swabbed the wound and went out. Without saying a WORD to my mother. My mother said she was baffled and thought that he'd come back. But then when the nurse came in and started to hook my grandmother up to an IV, my she asked if the doctor would come back and was told "No." and that he just said to start my grandmother on antibiotics. Now, my mom said "Ok, but wait a minute, she is already ON antibiotics - can she be on two? Is it safe?" The nurse looked surprised and said he wasn't sure - he wasn't aware that my grandmother was on antibiotics. This set my mom off. She had had enough. She told him she was just so frustrated because she didn't know what was going on. First of all, she was insulted that the doctor wouldn't speak to or acknowledge her or my grandmother. That he recklessly ordered antibiotics before even checking to see if she was on anything. That he disappeared before my mother had a chance to ask any questions about the treatment, next steps, how long my grandmother would have to be there...She said the nurses heard her annoyance and stepped it up, being extra attentive to my grandmother (and my mom said that they were great) and who finally she managed to persuade to find the doctor.

Finally he came, looking annoyed. But my mother pulled him aside and kindly and calmly said "Thank you for taking the time to come back a second time. I know you are busy." Then she went on to tell him everything from her perspective. That when he  first came in, how he ignored them and didn't help even turn my grandmother over.  She pointed to a sign above the nurses station that read "Introduce - Acknowledge - Explain" and was wondering if that is supposed to be a practice of the hospital, because NONE of those things were done with her. That he just seemed so annoyed to be there. She told him how he can't treat people like this - that she is NOT a doctor, she didn't know what was going on but that she WAS worried and just wanted some answers. Her mother-in-law is in pain. And no one seems to care. She asked him why he became a doctor, because she thought doctors become doctors because they want to HELP people? She also reminded him that a doctor is a civil servant - and his job was to serve his patients.

This "I'm disappointed" speech resonated with him, she said, and he had the decency to look ashamed. He stammered out a half apology, explaining that he was just so busy but that she was right. Then he gave my grandmother a proper and thorough examination and explained to my mother why he took the swab, what they were looking for and next steps. All that she wanted in the first place. She said that when the doctor left, one of the nurses (who had overheard the conversation, even though my mother told me she intentionally spoke softly because she didn't want to chastise the doctor in front of other staff) gave her a grin and thumbs up and said "Good for you for standing up for yourself - they need to hear it sometimes!"

I was so sad to hear this, though I know this must happen all the time. Its shameful.

I understand that being a doctor, especially in a specialty like ER where they are over-worked and often exhausted, is hard. But most jobs are hard and no one forces people, at least here in Canada, to become a doctor. This is a choice, a choice made with free will.

I hope that if I ever do get the privilege to be a doctor and practice medicine I will remember that. On those days and nights where I'm tired and possibly will hate my job, I need to remember that this is my JOB and that no-one forced me to do it and to remember why I did it in the first place.

One thing that bothers me sometimes, when people discuss these types of stories, is that they excuse the manner or attitude of the doctors away and say they don't care, as long as they are smart and good doctors and ask, "well, wouldn't you rather have a smart doctor who is rude over someone who is nice but dumb?"

Obviously, I'd *rather* have a very smart and competent doctor who is an asshole over a nice but stupid one, however I also think that its possible to be both. I really hate when people use that argument, as if somehow being kind/compassionate and intelligent are mutually exclusive. Or that being an asshole is a sign of intelligence.There are smart people in every industry and let me tell you, no matter how smart you are, if you spoke to your client the way some doctors speak to their patients, you'd be fired faster than you can roll your eyes. 

My husband thinks that its inevitable that most doctors will be assholes because they are witness to so many awful things and they are over worked etc. But I disagree. Sure, most will become a bit desensitized to a lot of these things, but that doesn't mean they can't at least pretend to care and be polite to their patients. Like I said, in other industries, people do it all the time, why shouldn't doctors be held to the same standard?

2 comments:

  1. This story really resonated with me, because of my own experiences with the terrible health care system in ontario. It's gotten to the point where I don't trust any doctors at all due to all the negative experiences and the misdiagnosis that so many people I know have received, and its interesting because I always wanted to be one myself.

    My own grandmother was in the hospital after she fractured her hip a few months ago, and we actually stayed with her 24hours/day for the 3 weeks she was there. And even then the nurses actually ignored her chest pain to the point where she had a heart attack, until finally we were able to convince a wonderful nurse to actually pay attention to it and then of course once the mighty lab tests confirmed it, they finally took action.

    Of course our adventure didn't end there, because against our judgement she was transferred to a rehab center, where everyone insisted she walk to the bathroom at night no matter how many times we mentioned that she used a commode at home, well when she attempted to get up and go to the bathroom she got hypotension and fainted. Not once but 3 times, and each time the doc would send her back to the ER to 'figure out what it was' and everytime all tests would come back normal. We actually pleaded with the doc to stop the midnight bathroom trips and to stop sending her to the ER but he refused. After the 3rd time, we got so frustrated that we signed her out AMA and took her home. I can't say it was easy, but she started getting better right away and we realized the hypotension was because she couldn't eat the hospital food and lost a lot of weight. Note, after 6 months at home she is now able to walk outside by herself with a walker.

    Honestly I would rather have a nice doctor that takes the time to listen to me over one that is a genius. Because the genius will and does miss things because they never listen.

    Sidenote, If the pressure ulcers aren't healing, there are actually other ways to improve their healing rate such as using Ultraviolet and ultrasound therapy. There is a really good wound care clinic that is run by a PT (Ethne) in Mount Sinai that has a good success rate.

    http://www.mountsinai.on.ca/education/cooperative-education-and-allied-health/rehabilitation/ethne-nussbaum

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    1. What a horrible story! I'm glad you took your grandmother home.

      And thank you for the information on the pressure ulcers! I'll mention the treatment to my parents and see what they think.

      Thanks again!

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