His voice shook.
“She’s in ICU. I thought you should know.”
I felt my body grow cold. She and her family had been patients of mine for almost ten years. She was so young. Younger than me, in fact….
“They aren’t sure if she is going to make it.”
“What happened?” It was supposed to be a simple cyst removal.
“Her small intestine was perforated. They have her belly open, said they couldn’t close it yet.”
I had used a new surgeon, someone I had never used before, because the mass was blocking the tube from her kidney to her bladder, causing quite a bit of pain and endangering the kidney itself. She needed surgery quickly and no one that I typically used was available to work her in.
“That’s just awful. Keep me posted on how she’s doing. I’ll be saying a prayer for her and for you.”
As I hung up, the guilt welled up. I felt personally responsible for the bad outcome, even though my hands weren’t the ones actually in her belly. MY hands had hit the referral button, signed the order.
She trusted me.
She ended up making it, but it took a huge toll on her both physically and emotionally and financially. It affected her relationship with her husband. It affected her kids. They had almost lost their mother and it left them all shaken and ungrounded for almost a year. Things are only now starting to look up.
I feel guilty when patients don’t like someone I refer them to. I feel that I have let them down. I feel guilty when I find a cancer, as if somehow it was my fault. I should have prevented it. Maybe I could have found it sooner somehow? And, yes, I feel responsible for surgical errors and outcomes.
So when I tell patients they need to see a different specialist than the one they picked out, I worry how far to push it when they aren’t agreeable. When I know a back surgeon is bad, how much do I tell a patient who is not listening to my gentle suggestions to seek a second opinion elsewhere? Where is the line professionally and legally?
These are my thoughts on this Monday morning…..