Ahhhhhh. I'm on break today - I was reading my last post and I don't think I gave my wife enough credit, her rotation IS harder than mine - I do have the 30 hour calls every 4 days but she works from 5am till 7pm every day and she'll do it straight through for a month - no days off (she did take a half day off a week ago...that was nice...turns out she miss read the schedule and wasn't supposed to though).
Anyway I thought I'd take a second to talk about crazy people. Beings how hospitals are places for sick people, it stands to reason that we tend to attract all kinds of nuts...I'm not just talking about the doctors and nurses ;P Occasionally, you run into someone that you just can't understand - there is no logic in there action and none of what they do makes sense...in adult medicine it's a lot less painful to watch these people make poor decisions that effect their health...it is after all their life and their choice...but what happens when one of these people is a parent, and the poor decision their making doesn't effect the adult but instead is effecting their innocent child?
It was late evening two days ago now, I was on call. I got paged to a new admit. It was a small little boy named Alex. He was a pretty cute little guy - just over a year, he had been previously health...until he stopped walking or even sitting up. For the last 2-3 weeks he has been laying on the ground and would not get up. If you try to make him stand or sit he will scream out in pain. This mother has taken Alex to several different hospitals, each doing their best to figure out whats going on. What I get is all the records of previous testing for this little boy. So far despite other hospitals best efforts the best we can say from the massive amount of testing ran is that there is something causing a major inflammatory response in his body. This is one of those things that is causing such a response, we know that we WILL find it...it's not one of those things that goes undiagnosed and then disappears...this will likely continue to become more and more of a problem as time goes on.
Alex's problem is two fold though, not only does he have a serious problem already effecting him, but also he has a mother who has really poor coping skills. As I admitted Alex, I thought I caught a hint of it here or there in the way the I gathered the history...for instance you ask a concerned parent, "Did the vomit have blood in it or green bile?" and the parent responds (instead of a quick "no" or "yes"), "uhhhhhhh...I...don't know....".
Why wouldn't you know facts like that about your child. Anyway as time went on it became increasingly apparent that Alex wasn't at the top of her priorities list...the mother's excuse list was a mile long...never ending and it was impossible to get to the bottom of it and figure out what was really bothering her, it just seemed like she HAD to get out of the hospital as fast as possible and she would make up any excuse necessary to do it...none of which were very good. Throughout the rest of the morning I was intermittently called back to her room to argue for the child's benefit - someone needs to find out what is wrong with Alex and it's not going to get done if she keeps leaving hospitals AMA (against medical advice) which is what she has done with the last two hospitals (and what she is planning on doing with us). She is demanding, she is unreasonable, and she is shows a general lack of concern for her child! I had my "mask" on like it was my face, I honestly have never been so two faced in my life. Talking to her all the while with compassion and faked understanding, trying to remain calm, as she slowly brought up reason after pathetic reason for her to take her child out of the hospital.
"I have school on monday." -- "I'm not doing well in school." -- "My kids are at home with my grandmother." -- "I don't like hospitals." -- "People will think I'm a bad mother, if I leave my kid alone in the hospital."
We discussed that she didn't have to be here all the time. Her husband even said he could be here for some of the time and we are a children's hospital - set up for really sick kids and parents that can't always stay 100% of the time with their children. We have social workers that can help her school understand what she is going through and cut her some slack.
Every issue she had (there are many more than I listed - all equally small concerns compared to your child) we addressed. However, it would only be another hour or two until she would call again wanting to leave. She would have the same exact concerns - no different than before. We would speak with her regarding those concerns (basically saying the same thing as before). This happened four times before I left. On the fourth time, we had had enough and simply told her unless she had something new to say, she knew that she could leave if she chose to - however we recommended against it for her child's sake. I went off post call that afternoon...something tells me she's left by now.
I've seldom felt so much frustration and rage, wanted so desperately to direct it at one person, and been unable to. Instead I had to play the doctor role...her kid is really sick and she cared more for her own comfort than her child...I wanted to punch her in the face...but I didn't, I remained cool and collected...and I did the "right" thing.
Newbie Doc
What I wrote right there makes me feel really immature and emotional, but it's how I felt, right or wrong...it's how I still feel.
