The Dilemma by Ted Bacharach MD (retired)

ng

We had just settled down after a delicious meal when the telephone rang and the doctor on call was wanted. Fortunately, it was not me but the doctor whose home I was visiting. The doctor was on-call for a colleague.  It is always difficult covering for another physician. The call was from a nursing home regarding a 87 yr old male patient. He had been a patient in the nursing home for two years and had “gone bad” earlier in the evening. The question was, should they send him back to the hospital or keep him comfortable?  Two years earlier the family had requested “no heroics”. but on this evening the wife was visiting and wanted everything done.  She changed her mind because she wanted him to make it to Christmas ,which was still eight days away. She remarked that he had always enjoyed Christmas so much and she felt obliged to do everything to keep him alive till then.

The dilemma for my doctor friend was to come up with the proper decision.  The options were to send the patient to the hospital so he can be intubated and kept alive,  give him an extra dose of some medication to keep him there or, lastly, try to talk to the wife about the decision she had made two years ago.

The results of a wrong decision could result in a malpractice suit.

My conclusion was that it was great to be retired.