(Snippets from the frontline)
They prey on medical ignorance
She arrived in the emergency room with nausea and vomiting.
Labs were drawn, and a CT scan of the abdomen was ordered.
The family arrived and told their 92 year old loved one was on hospice based on the scan revealing metastatic liver cancer. The hospital Palliative Care team gave their condolences.
The family asked questions: “What were the lab results of the liver function tests? Could a liver biopsy be done? How did this scan compare to previous ones done at the hospital? Why did she lack constitutional symptoms of decreased appetite, weight loss, or fatigue?”
Liver lab tests were normal. The ensuing biopsy was negative for cancer. A scan from 8 years prior was compared and was without change.
Hospice was stopped. The patient was discharged a week later with a diagnosis of stomach flu.
She was my mother.
Fortunately, my brother and I are geriatric, palliative, hospice care doctors.
Most of you are not.
Hospitals sometimes prey on medical ignorance, but one can still fight back. Technology puts resource information in our hands. Use your computer, ask questions, get answers, and don’t be afraid or denied.
My mother is 97 years old and still lives at home.
Gene Uzawa Dorio, M.D.
I loved this post! No one will take charge of one’s medical care as well as oneself (or their loved ones that will advocate for them). Sadly, accepting hospice when unneeded, can lead to what I deem “psychological death” or the will to let go. Your mom raised some smart kids.
Dr. Gene, this is a great anecdote about caring for elderly family members. It really brings home the need of checking the diagnoses. Well done!