I took this off one of my heart parent lists, I know we alwasy tell people how important it is to be w/ a family member (IF possible) while in the hospital, so it's interesting to see it from a doctors perspective, Lyn
Here's the link:
http://www.nytimes.com/2006/09/19/health/19case.html
Since registration is required, I'll just invoke "fair use for educational
purposes" and post it below.
NEWSclips Date: September 19, 2006
Overattentive families may be underrated
By David A. Shaywitz, M.D.
New York Times
It´s every physician´s fear: the patient with the "involved" family,
relatives who watch over everything, question everybody and make a nuisance
of themselves. Yet, in today´s world of rapid-fire medicine, such relatives
may be a patient´s most important advocates.
The example that always sticks in my mind is personal. A relative of mine,
Jeremy, was operated on by one of Harvard´s leading pediatric surgeons.
After the procedure, Jeremy never seemed to be able to catch his breath
fully. "Not to worry," the surgeon briskly intoned. "Perfectly normal for a
long procedure."
Fortunately, Jeremy´s parents - both physicians - monitored him, especially
as his breathing grew more labored. When they insisted on speaking to a
senior doctor in the middle of the night, over the strenuous objections of
the resident physicians, it was just in time, as Jeremy required a breathing
tube and barely survived the ordeal.
Years later, a similar experience occurred with another relative of mine,
Beth, who had just been through a major abdominal operation. Beth´s mother,
a physician´s assistant, insisted on spending the night after surgery with
her at the hospital.
Good thing. Around midnight, Beth told her mother she was feeling woozy and
was having trouble catching her breath. "She´s fine," the nurses assured the
mother. But the mother knew something wasn´t right and demanded that the
surgeon be called at home. It turned out that Beth´s internal stitches had
come undone and that she urgently needed additional surgery. Without such
hypervigilant advocates, Jeremy and Beth might not be with us today.
This brings up a delicate and dangerous question of responsibility. Surely,
it belongs to the physician rather than the patient, right? After all,
doctors are supposed to make sure the patient gets the best care available.
That´s the theory. The reality of today´s clinical care is that in general,
doctors don´t care as much - and perhaps, simply can´t care as much - about
a patient as the patient´s family does. Doctors have responsibilities for
scores of patients at the same time, and spend much of their time focused on
the patients who seem to be the sickest at that particular moment.
I remember the feeling of utter dread I routinely experienced as a medical
resident when I was on call overnight and when the other residents would
sign out their teams to me. A patient´s entire medical history would be
reduced to a sentence: "84-year-old male with congestive heart failure and
Type II diabetes, admitted with pneumonia." and perhaps a to-do item: "check
the final read on the chest film." Beep, beep, beep, my pager would go off
at 3 a.m., and I would desperately flip through my sign-out notes, trying to
learn something about the patient as I rushed toward his floor.
I remember, too, the guilty impatience felt on morning rounds toward the
families who would always have one more question or who wanted to share one
more insight about a relative for whom our team was caring. Impatient
because we had 25 more patients to see by the end of the morning, and guilty
because their questions vividly reminded me what a small amount of my
overall attention I was able to give most patients, especially when our team
was preoccupied with a patient who was crashing somewhere else in the
hospital.
I´ve also seen numerous cases in which hypervigilant families actually
ensured that their relative received worse care, families so irritating that
everyone avoided their room unless it was absolutely essential.
The most effective families, it seems to me, are those who genuinely
appreciate the efforts of frequently overwhelmed health care providers and
who seek to work with them to help care for their relatives. At the same
time, as a concerned family member, you may know the patient better than
anyone else, and if you see something that doesn´t seem right, speak up. The
doctors may not thank you, but perhaps they should.
---
Dr. David A. Shaywitz is an endocrinologist in Boston.
Here's the link:
http://www.nytimes.com/2006/09/19/health/19case.html
Since registration is required, I'll just invoke "fair use for educational
purposes" and post it below.
NEWSclips Date: September 19, 2006
Overattentive families may be underrated
By David A. Shaywitz, M.D.
New York Times
It´s every physician´s fear: the patient with the "involved" family,
relatives who watch over everything, question everybody and make a nuisance
of themselves. Yet, in today´s world of rapid-fire medicine, such relatives
may be a patient´s most important advocates.
The example that always sticks in my mind is personal. A relative of mine,
Jeremy, was operated on by one of Harvard´s leading pediatric surgeons.
After the procedure, Jeremy never seemed to be able to catch his breath
fully. "Not to worry," the surgeon briskly intoned. "Perfectly normal for a
long procedure."
Fortunately, Jeremy´s parents - both physicians - monitored him, especially
as his breathing grew more labored. When they insisted on speaking to a
senior doctor in the middle of the night, over the strenuous objections of
the resident physicians, it was just in time, as Jeremy required a breathing
tube and barely survived the ordeal.
Years later, a similar experience occurred with another relative of mine,
Beth, who had just been through a major abdominal operation. Beth´s mother,
a physician´s assistant, insisted on spending the night after surgery with
her at the hospital.
Good thing. Around midnight, Beth told her mother she was feeling woozy and
was having trouble catching her breath. "She´s fine," the nurses assured the
mother. But the mother knew something wasn´t right and demanded that the
surgeon be called at home. It turned out that Beth´s internal stitches had
come undone and that she urgently needed additional surgery. Without such
hypervigilant advocates, Jeremy and Beth might not be with us today.
This brings up a delicate and dangerous question of responsibility. Surely,
it belongs to the physician rather than the patient, right? After all,
doctors are supposed to make sure the patient gets the best care available.
That´s the theory. The reality of today´s clinical care is that in general,
doctors don´t care as much - and perhaps, simply can´t care as much - about
a patient as the patient´s family does. Doctors have responsibilities for
scores of patients at the same time, and spend much of their time focused on
the patients who seem to be the sickest at that particular moment.
I remember the feeling of utter dread I routinely experienced as a medical
resident when I was on call overnight and when the other residents would
sign out their teams to me. A patient´s entire medical history would be
reduced to a sentence: "84-year-old male with congestive heart failure and
Type II diabetes, admitted with pneumonia." and perhaps a to-do item: "check
the final read on the chest film." Beep, beep, beep, my pager would go off
at 3 a.m., and I would desperately flip through my sign-out notes, trying to
learn something about the patient as I rushed toward his floor.
I remember, too, the guilty impatience felt on morning rounds toward the
families who would always have one more question or who wanted to share one
more insight about a relative for whom our team was caring. Impatient
because we had 25 more patients to see by the end of the morning, and guilty
because their questions vividly reminded me what a small amount of my
overall attention I was able to give most patients, especially when our team
was preoccupied with a patient who was crashing somewhere else in the
hospital.
I´ve also seen numerous cases in which hypervigilant families actually
ensured that their relative received worse care, families so irritating that
everyone avoided their room unless it was absolutely essential.
The most effective families, it seems to me, are those who genuinely
appreciate the efforts of frequently overwhelmed health care providers and
who seek to work with them to help care for their relatives. At the same
time, as a concerned family member, you may know the patient better than
anyone else, and if you see something that doesn´t seem right, speak up. The
doctors may not thank you, but perhaps they should.
---
Dr. David A. Shaywitz is an endocrinologist in Boston.
