Tuesday, January 29, 2013
Ms. Cantrel sat on the clinic room chair panting, like there was no air left in the room.
“Dr. Mash” she said as if taking her last breath, “If I could just get an oxygen tank to take home I’m sure I’ll be fine.
I had just taken care of her two weeks previous at the hospital. She was treated there for a pneumonia (an infection in her lungs). At the time I had given her antibiotics in an IV and she did very well. I had sent her home with antibiotic pills and strict instructions (and an appointment) to see me the next week to make sure she was getting better. She was actually feeling so much better that she cancelled her appointment. Unfortunately, she started coughing again and then had fevers. She sat in front of me having developed another pneumonia. After listening to her lungs again I sat carefully down in my chair.
I paused to make sure I chose the correct words. “Ms. Cantrel, I am so sorry, but I am sure you have developed another pneumonia and need to be admitted to the hospital again.”
The words sank in, and I could tell she had no intention of going back into the hospital. Sadly, Ms. Cantrel had had more than her share of hospital experiences. 4 months ago, I did a colonoscopy on her and found a large mass in part of her colon. I immediately referred her to a colon surgeon that I respect, and he had to take a large portion of her colon out. She had to stay for about 2 weeks in the hospital recovering.Then only a few weeks later, I admitted her to the hospital again to treat her for the pneumonia. The type of antibiotics that I gave her then were more complicated, and she needed to take them longer than normal so she stayed again for about 10 days. Finally, she was released home. Only to see me again in the clinic room during this visit, with the news that she had to go back.
I could see the horror in her eyes like a gigantic Tsunami about to crash into her.
I spoke quickly this time, “Ms. Cantrel, let me tell you a story. Many years ago I was a resident. I was working 120 hours a week. Once every other month, we would get an entire weekend off. We called it our ‘Golden Weekend’. On one of those, my wife and I decided to celebrate and go snowboarding. that day though I fell and landed on my right side. I had this horrible pain and had to sit for a while. I thought at first that I had knocked the wind out of myself, but the pain slowly got worse. I finished snowboarding and went home. That night I could barely sleep because of the pain. I thought that maybe I had bruised or even broken a rib. The next morning I woke up and rounded on my patients at the hospital. By the end of that morning, I could barely walk. The pain was unbearable, so I finally agreed to go to the Emergency Room. There, the ER doctor ordered a CAT scan and found out that I had a liver laceration -a tear in my liver causing it to bleed. It was pretty scary. I had to be admitted to the hospital and monitored to see if the bleeding would stop. Every day was agonizing. I was in horrible pain, I was getting blood tests all the time, and the bed was unbelievably uncomfortable. Worst of all, I could have died from this. I might have needed surgery to stop the bleeding. It was horrible. Finally after 6 days of agony, my bleeding stopped. I was able to go home. I remember about 3 or 4 days later I was sitting on my couch at home and suddenly I had a terrible pain in my side. I remember thinking that I might have a bleed again. But what is amazing is that I remember vividly thinking: “I would rather die than go back to the hospital.” I did not want to deal with that experience again”.
I stopped my story to let Ms. Cantrel gather the point. “So Ms. Cantrel, believe me when I tell you that I understand that you don’t want to go back there. But I promise you we have no other choice. I promise I will do everything to make you feel better quickly. “
Ms. Cantrell sat panting. “Okay Dr Mash, I’ll go. Thank you for understanding.”