That is the only logical explanation for the way his son treated his father. This patient was elderly (I think about late 80’s) who was completely demented and paralysed from strokes, bedridden, and suffering from chronic lung disease and decubitus ulcers. He was frequently in respiratory failure and septic. His chance of meaningful recovery? Zero. Here is the sad part. He lived at home with a 24 hour nurse and his physician (I think he was an internist) son. His son managed his medical care until he had to be brought into the ER (which was about once a month). The son basically ran a mini ICU at his house to keep his father alive. He bought a BiPAP machine (a step shy of a pure ventilator for intubated patients) for when his respiratory effort was failing. He had a pulse Ox machine. He had infusion pumps. He had placed a PICC line (a peripherally inserted central line for better IV access) in his arm. He would buy intravenous drips for his father – including the antibiotics vancomycin and Zosyn for his MRSA and other pneumonias, IV saline and lactacted ringers solution, as well as IV push medications like Lasix (a diuretic), Digoxin (for heart failure), adenosine !(since he had gone into SVT (a type of cardiac arrhythmia that is treated emergently with the somewhat dangerous drug, adenosine), and God knows what other ones. Once he brought his father in by EMS after calling the ER (as he always did ) beforehand to tell us everything he had done at home – which in addition to receiving multiple antibiotics, included him mixing up and starting an Epinepherine drip by mixing several Epi Pens into a bag of saline and running it in! He came in on his BiPAP, with the epi drip running and with a 16 gauge IV running wide open IV fluids. He had a foley catheter in place with no urine output. This poor guy was basically on full life support at home for his septic shock. In many of the staff’s opinion he was being kept alive unnecessarily (including the doc that used to admit him since his son did not have admitting privileges at our hospital).
Then one of my colleagues offered an explanation. He must have been the WORST father ever. He must have beaten his kids and his wife. How else could you explain why his physician son would keep him alive and suffer like this?
I don’t want to upset those who supported Terry Schiavo’s staying on life support but here was a case where a guy’s time was up – and his son elected to torture him by keeping him alive. My colleague’s opinion was the only one that made sense to me.
Wow, what a sad story.
Appears to definately transgress some moral if not ethical boundaries.
Maybe he just couldnt deal with the fact that he is a doctor, and still couldnt “heal” his father’s problems.
It’s too bad when emotions gain control, instead of our minds. Bad things generally happen, even if for (mostly) honorable reasons.
Wow.
Maybe he was trying to be more scientist and less doctor. In other words, he treated his dad like his personal science project, just to see what he could do.
So instead of being immoral he was being amoral?
I think it’s more likely he just couldn’t let go, however.
Yes, I thought that was possible too. I just don’t know how he watched him suffer all that time and was still able to prolong it.
How’s it any different from all the people who won’t let go of their decaying relatives in the ICU? Just because it was at home? If anything I think it’s less awful; he was sacrificing his personal time, life and money to keeping his father alive. Which is far better than the all-too-frequent “I can’t deal with this now- you keep him alive with all possible measures and I’ll be back in a few days”. Granted, neither is ideal but I don’t see this being any worse.
perhaps the guy had blinders on when it came to his family and he was in total denial?
#7 has it. There isn’t a logical explanation. (Why do you pretend there has to be?) The son had lost all objectivity that in treating a patient one should have. He was treating a family member, something I was clearly warned not to do when I was in medical school, for that very reason. With your family, you can’t always count on the quality of objective thinking and judgment you would otherwise be able to bring to a physician-patient relationship. Psychologically, a stronger and possibly conflicting relationship already exists with family members.
New blog
and who advocated for the father when he came to the ED? Nurses are supposed to be the patient advocate, did anyone contact social services?
Yeah, social services was all over it – but there was really nothing they could do. The son was competant and was just making some bad decisions.