When a doctor is JUST doing his job

Try to be an informed patient. Be mindful of your options. Hindsight is bliss. In every case where a difficult decision needs to be made in healthcare it is easy to see what the best thing to do is after it is all over. What do you do when in the midst of a difficult decision? How do you disagree with your physician? How do you NOT take her advice?

You must keep yourself informed and ask questions..If you disagree with the physician tell her but try not to be defensive. Most doctor’s practice within the realm of their specialties. All doctor’s are not schooled in all forms of practicing medicine. They suggest treatment accordingly. For example, usually a dermatologist will not suggest guided imagery or acupuncture for acne. Even when other treatments have failed. Also, when SYMPTOMS can be relieved from certain treatments that’s what is suggested. Doctor’s are creatures of habit just like the rest of the human race. Sometimes their decisions are routine, sometimes it’s business, sometimes they just don’t know what is best for the situation at hand. At times, these treatments are not in the patient’s holistic best interest. We’ve all heard horror stories of over-extensive surgery and chemotherapy that killed the patient before their migrating malignancy.

I recently spoke with a patient’s family about his treatment. The patient was in his late 80’s, just recently became very sick with failing kidneys and a build up of fluid that was causing respiratory distress. He was awake, alert and oriented. He was as pleasant as always. He was appreciative of all the doctors and nurses do for him. “No CPR” was a common order when patient’s do not want to be resuscitated.

How do you watch a patient slowly lose his breathe when maybe you could help him breath again? Maybe, you can offer some comfort.

He worsened. A Morphine drip was not considered. Ativan wasn’t even prescribed in case of increased anxiety that which is very common with respiratory problems. Hospice was not agreed upon by the doctors. It seemed this patient wasn’t sick enough, yet.

Dialysis was suggested. Immediately and then 3x week until death. Dialysis helps a great deal of people by doing the work their own kidneys no longer do…it is often tiring and depressing but it prolongs life and for some that is reason enough to endure these treatments. Many of these patients, on their “off” days function quite nicely. This man had to undergo a short procedure surgery to install an access for the dialysis machine and eventually his veins and arteries will be sewn together at a site in his forearm (takes several weeks to heal before using) for the future dialysis treatments. His daughter was distraught. She hated to see him suffer. His breathing was worse. Dialysis seemed to help only slightly. She didn’t want to seem mean or uncaring but this all seemed ridiculous. She didn’t want him to die but she didn’t want him to suffer. He, on the other hand, was not complaining. I’m sure she prayed. When doctors no longer seem god-like to us, we often go to the real thing and ask Him to decide.

I believe there is a reason for everything that happens here on earth. This man was known to be a good, happy, soulful human being. God knows that.

His daughter witnessed her father crying out the night she took him home. He spoke to relatives previously passed. He seemed scared and then he seemed peaceful. Before the ambulance arrived to pick him up for his scheduled dialysis treatment he died. We believe he was in peace.

Some things are better when they are decided for us. It just depends on who does the deciding.

Please be an informed patient.