I’m frustrated and mad the more I think about this.
My grandmother started doing strange things in 1992. She was
in her 80’s and we thought it was just her getting old. We took her to the doctor
that was her and my mom’s family physician. He said she was fine, just getting
older.
Then she got to the point that we had to take the keys away
from her so she couldn’t drive. She almost got herself and my mom killed by crossing
lanes on a 4-lane highway with a large median and heading toward a tanker truck
that was coming towards her. My mom had lost her vision due to diabetic retinopathy,
so she depended on my grandmother for transportation.
Then a few years later we were eating at the table. My mom,
her sister and family were gathered around. Nana (that is what we called her)
had lost the capability to cook (she was the only one who did the cooking when I
was growing up), the doc once again said it was just old age, “old timers” as
he called it. We asked about dementia. Nope, she was just getting old.
My Nana was no fancy smancy lady, but she had manners. So
the night when she went out on the porch (we lived on the “mill hill”) and
squatted in front of God and all the neighbors and took a pee I called BS.
We took her back to the doc the next day and explained what
had happened. Nope, there was no problem. This went on for 6 years. Now I have
no medical degree and neither did anyone in our family, but we knew that
something was up.
One day Nana fell and wound up in the hospital. Guess
what??? The attending physician referred a neurologist to visit her in the
hospital and the dementia diagnosis was given. Seems we were right, she had
battled the disease when we first suspected it. I never could understand why
the doctor couldn’t see it. But is was too late. 6 months later she was dead.
Granted, when we would take her she did act decent and as
though she were in her right mind. She could answer the simple questions that he
asked. But the doc should have figured out that we may know a little bit about
what we were telling him. Had he pressed her more he most likely would have
discovered there was more than meets the eye. Even having her do a battery of
tests could have been warranted that would have tested her mental capacities.
Fast forward to today. I’m talking to a local Alzheimer’s
advocate about why people aren’t getting diagnosed earlier in the stages of
this disease. She told me, “most of the doctors simply do not want to
acknowledge that the patient has something that can’t be cured. They are
trained to fix things, and (as of the time I’m writing this), there isn’t a
fix.” So the doctors choose not to tell. They may prescribe the medicines, but
they will either forego explaining what the med does, or they will tell them it
is for something completely different, even though they know it is a lie.
DAMN! Now, do you see why I’m mad?!?!?!?!?
Here is the Hypocratic Oath that was adopted in the 1960’s.
I swear to
fulfill, to the best of my ability and judgment, this covenant:
I will respect the
hard-won scientific gains of those physicians in whose steps I walk, and gladly
share such knowledge as is mine with those who are to follow.
I will apply, for
the benefit of the sick, all measures [that] are required, avoiding those twin
traps of overtreatment and therapeutic nihilism. (notice that they will apply their knowledge and ALL FREAKING MEASURES
that are required and it is for the BENEFIT of the sick. If you don’t tell the
patient, how can you expect them to benefit???) I’ll talk more on this point
later.
I will remember
that there is art to medicine as well as science, and that warmth, sympathy,
and understanding may outweigh the surgeon's knife or the chemist's drug. (IN
OTHER WORDS, LISTEN TO THE PATIENT AND THEIR FAMILY!!!!)
I will not be
ashamed to say "I know not," nor will I fail to call in my colleagues
when the skills of another are needed for a patient's recovery. 1 WORD “REFERRAL”
I will respect the
privacy of my patients, for their problems are not disclosed to me that the
world may know. Most especially must I tread with care in matters of life and
death. If it is given me to save a life, all thanks. But it may also be within
my power to take a life; this awesome responsibility must be faced with great
humbleness and awareness of my own frailty. Above all, I must not play at God. “enough
said”
I will remember
that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family
and economic stability. My responsibility includes these related problems, if I
am to care adequately for the sick. (When the family doesn’t know for sure,
they can’t prepare adequately, therefore you are not keeping your oath doctors
when you fail to talk candidly with the family and loved ones about the patient
and what may lie ahead.)
I will prevent
disease whenever I can, for prevention is preferable to cure.
I will remember
that I remain a member of society, with special obligations to all my fellow
human beings, those sound of mind and body as well as the infirm.
If I do not
violate this oath, may I enjoy life and art, respected while I live and
remembered with affection thereafter. May I always act so as to preserve the
finest traditions of my calling and may I long experience the joy of healing
those who seek my help. (Herein lies the problem. “may I long experience the
joy of healing those who seek my help.”) DOCTORS, you CANNOT skip over the other
parts of this oath and cling to this one, writing off those you know where
there is no cure!
Here is another way to look at it.
Scenario 1: A patient comes in and through testing you find
that they have a cancer that is stage 1 (whatever). No patient has ever been
cured, but there are drug therapies that have shown promise at greatly slowing
the disease. You choose not to tell them what is wrong, you simply tell them
that they are tired and hurting but you can prescribe something that will make
them feel better. They go home and take the pill, but the disease progresses
until stage 4 and too many of their loved ones are suspecting cancer because of
the signs. You “run” some tests again and tell them that they have stage 4
cancer. No treatment will be effective at this stage, but if they’d like you
can try it, or you’ll refer them to hospice where they can be comfortable until
they pass. Many cancers feed on SUGAR and will EXACERBATE the condition, but this person won't know to at least change their diet BECAUSE YOU DIDN'T TELL THEM!
Scenario 2: A patient comes in complaining of symptoms that
could be the flu or at least a pneumatic problem. Through your talk with them
you discover that they have multiple partners and hate the thought of having to
use any protection. A blood test will confirm your worst fear, HIV. Knowing the
stigma that HIV brings, you tell them that they have some sort of infection
affecting their breathing and give them a drug that has shown promise in HIV
patients. You explain that it may take a while to feel better, hoping that the
medicine will buy them time. BUT, you’ve now sent someone on their way who can
continue to go our and unknowingly infect many others because of their
lifestyle.
Scenario 3: A patient comes in complaining of tiredness,
trouble going up hills or walking any distance at all. You run tests and
discover that they have Congestive Heart Failure. There is no cure, but there
are treatments with oral drugs that can be given. A diuretic will draw the
fluid off and make them feel better. You admit them overnight in the hospital,
run IV diuretics for a day, pull down 15-20 pounds of fluid. The patient feels
great. You send them home with the pill, maybe combined with a blood pressure
med (tell them they need this bp med as it is newer and better) and hope for
the best. Meanwhile the person who needs to step up their activity and cardio strengthening
goes back home to the couch where they have resided for the past few months.
They continue to battle the buildup, but you never tell them until the heart
attack happens and it is too late to do anything.
DOCTORS! Answer me this. Would you really do any of these
situations? If so, which of the 3 do you think is OK? NONE YOU SAY?!?!? Well
then, why are you doing the same thing to patients who have other incurable
diseases, just because of the stigma that may be attached.
I’m not one who likes to think about government regulation.
I think that the government needs to butt out of people’s business. But when it
comes to deception, which is what this is, the powers that be need to hold
someone accountable.
I would like to see a bill passed either at the state level
for each state, or preferably at the national level that would prevent any of
these scenario’s from ever happening again. I would call it the “Right To Know”
Act. It would state that the moment a physician knows or suspects a diagnosis,
they are required to tell the patient and/or the family about what they suspect
or have found. This would put the burden on the family and patient. The
physician would give them all the options and they could choose. If they don’t
do anything about it, then the physician is relieved of any responsibility. But
any physician that fails to do as such, would be subject to a license review
and possible forfeiture.
BUT, let me say this. I’m not saying all doctors are bad. There
are plenty of them that are upfront and tell the patient and the family what is
going on. I’m lucky enough to have that kind of medical care. I understand no doctor
wants to be faced with something that can’t be fixed. They don’t want to feel
like they failed someone because they could not provide a cure.
But withholding information is failing someone. It is
preventing someone from actively searching for the next steps and developing a
plan and solution for their care going forward. Deception is rarely excusable
unless the reveal could cause irreversible traumatic damage.
We have to move forward and get more doctors and families to
be more proactive in the patient care to the utmost fullness that is humanly
possible. How do we do that? Like I said, I hate adding more regulations, but
unless we’re going to put this at the forefront of the healthcare sector of our
nation, this is needed to stop the madness before more people have to suffer
needlessly.
What are your thoughts on this? I welcome your thoughts and
what you have witnessed through watching and experiencing these situations with
your friends and loved ones. Together we can make a change for the better, but
we need to start the conversation NOW!
As always, #AlzSux #HydroWarrior4Ever! #EndAlz
