Insensible Losses: When The Medical Community Forgets The Family

http://content.healthaffairs.org/content/34/4/707.full

This article really makes any person or professional re-think the strategy they use to engage with patients and family. With a patient or clients permission, the family should be part of the diagnosis and assessment process along with the plan.

See part of the article below and review the link to read the rest…….

My patient, Steve, and his wife, Laura, sat in a hospital room waiting to meet the medical team. June days have balmy beginnings in North Carolina, but by noon our white coats are burdensome in the summer heat. I had been assigned to care for Steve during my internal medicine rotation. Nearing the end of my clinical year in medical school, I was increasingly eager to prove myself, to both my patients and my supervising physicians.

Steve was a vigorous man. At almost seventy years old, he was still hauling lumber and fixing faulty air conditioners. His body demanded a more energetic role than that of “patient.” Steve’s charm was evident within minutes—he pretended to be so beaten up by my routine physical exam that the only remedy for such “mistreatment” was extra pudding. But despite having the appearance and energy of a healthier person, Steve had been hospitalized for shortness of breath and low counts of all major blood cell lines.

During the medical team’s first visit to his hospital room, he and his wife showed us patience and deference. It was clear that they trusted us to know best. We ran a battery of tests, including imaging of Steve’s chest and studies of his blood. The results were concerning: a blood clot in the heart and atypical blood cells under the microscope. Signs were pointing to cancer, so we ordered a bone marrow biopsy.

The next morning, as we waited on the results of the biopsy, I went to check on Steve. Laura mentioned he was just getting over a terrible headache that had cropped up at dawn. The headache was troubling to everyone on the medical team, but that morning’s medication had controlled the pain and a neurologic exam produced no worrisome results. We reassured the couple that until the biopsy results returned, nothing else needed to be done. It turns out we were wrong…….