You are consulted to see a patient for possible surgery. On first meeting, he’s a great guy. But he’s 4+ sick. He had a heart transplant a number of years ago. Diabetes. COPD. And now he has an acute abdomen. He needs immediate attention.
He’s awake, alert, and competent. You’ve discussed the risks, benefits, and options. He is totally aligned with your recommendations.
The patient’s words are: “Doc, I really want to thank you for looking after me. I appreciate you being here for me. I’ve had a number of tough conditions over the years. Just do your best. I understand the risks.”
The patient’s son, at bedside, is also fully supportive, echoing similar comments.
Your patient has one request. “Would you be kind enough to call my other son, who lives 6 hours away, just to let him know what’s going on?”
The other son lashes into you – stating that the hospital has been incompetent from day one…all the doctors are just interested in cash…and that you’d better not screw up because he’s an attorney and will personally come after you if there’s a bad outcome.
That was not a positive trust building exercise.
You state you cannot comment on his dad’s past hospital experience as you just met him 30 minutes earlier. But he has a life threatening condition. And there are no good other options.
You hang up while the son is still venting.
Now what do you do?
Your patient is nothing but kind, civil, and appreciative. But, the patient’s lawyer son on the phone might become executor of the estate if your patient dies. And he would conceivably have standing to sue. Whether he would prevail is another matter.
On the other hand, the lawyer son is not your patient.
You’re the one surgeon on call. There’s no option to transfer to another facility. And, anything other than surgery – soon – will likely end in death. And even with surgery, the patient might die or experience a complication.
What do you do?
I’m sure I’ll be accused of lawyer bashing. So be it. This vignette is based on bona fide case.