The Cost of Protection

Carved flowers on a Victorian tombstone.
There have been several times over my career that I have had to step in to protect a patient from their family. Each and every time it gets nasty. It takes a certain kind of person to abuse their child or to molest a mentally challenged adult or neglect an elderly person to the point they have maggots in their wounds. Those kinds of people fight and they fight dirty.

I marvel at how some attorneys can look at the facts of a situation and defend it by attacking and terrorizing the physician who had to make the call. It is exhausting and terrifying and can leave you questioning yourself and your judgement throughout the process:

Surprise subpoenas summoning you to appear in court in 60 minutes, requiring you to cancel all of your afternoon clinic appointments at the last minute.

Threats of lawsuits.

Antagonist depositions. 

Lies and accusations made publically.  

Nothing in medical school prepares you for this sort of thing. Physicians have malpractice insurance but this is not malpractice. There is no one to walk you through it unless you hire your own expensive attorney.

Eventually you are vindicated but not before your life is made a holy living hell. It takes a toll on your family and friends as well, as you cannot discuss it with anyone else. The process can drag on for months or even years.

You are isolated and alone.

Fortunately, all of my experiences have been before social media. I have seen, of late, some unbelievably ugly online attacks made on physicians who are only doing their duty and trying to protect the vulnerable. It appalls me how quick the rest of the world is to jump onto the hate the doctor bandwagon when they do not know the whole story. Physicians are not allowed to defend themselves due to privacy laws. The rest of the world will never know the whole story.

What some people seem to forget is that our role as physicians is to assess the situation and make a recommendation. We are required by law to report suspected abuse. We are not omniscient super humans and maybe we don’t always get it right. All we can do is our best. In the end is up to the courts to decide guilt or innocence. 

The price we pay to do so is often very, very high….


110 thoughts on “The Cost of Protection

  1. I hear you. Seeing too much of that kind of thing really will take it’s toll on you. I’m on the bottom of the food chain, so people seldom listen to me anyway, but if I even suggest that something might be wrong, I’m instantly in trouble. Also, I’m in trouble if I don’t say anything, like how come you did not see this? Then there is having spoken up, not being believed, and being forced to just sit there and watch it all play out, knowing full well how it ends.

    First rule, always protect yourself spiritually and emotionally. People are always going to people. 🙂

    Liked by 1 person

  2. Oh, Victo, I’m so sorry to hear you’ve been through the legal wringer. It’s so unfair. But kudos to you for standing up to the abusers and neglectful caregivers despite the consequences to you personally. I think many doctors today refuse to get involved for just that reason, regardless of the oath they took.

    Liked by 1 person

  3. There aren’t enough superlatives to express my astonishment. Your job is tough enough with the day-to-day bureaucratic entanglements. That you must experience surreal legal nightmares such as you describe… I wish you strength.
    This blog should be required reading for medical school applicants.

    Liked by 1 person

  4. I was a visiting nurse for many years and it was my legal duty to report any suspected abuse. In teaching as well you are legally responsable to report any suspected abuse. I was on the front lines and sometimes in uncomfortable situations. I think we are ethically responsable to report suspected abuse. It would be very hard to be attacked for reporting what you are legally and ethically required to report. But you are doing the right thing.

    Liked by 3 people

  5. I really feel for you. It comes to something when you are put through the wringer for trying to protect someone. Not only that, they try to cast aspersions on your reputation and character. It must be horrendous,
    You have my utmost respect to keep going and for protecting those that can’t protect themselves, Dr Vic!

    Liked by 1 person

  6. I’m with Maggie – this should be required training in med school and in specialty training. My husband, a former teacher, had the same duty of care responsibilities as do all teachers in Canada and it can leave you shattered when what you are trying to do is keep someone safe.

    Liked by 1 person

  7. Same in Canada, you are legally bound to report any suspected abuse. What we would do would be to admit the victim to the hospital for observation and there would probably be more than one person to substantiate the report.

    Liked by 1 person

  8. “We” prefer simple answers to difficult situations. “We” often think that doing something, anything, is better than doing nothing. With good intentions (paving their ways) “we” create rules and laws, aimed at protecting a this or that or person or group, but we forget that there is also a Law of Unintended Consequences, and that our simple solutions to complicated problems can, and will, produce new sets of nightmares for equally innocent people, such as doctors reporting suspected abuse. Having your hands tied by both the requirement to report and the inability to adequately defend yourself against the retaliation and abuse directed to you is part of our inability to come up with well-reasoned responses to situations, and responses that can evolve as technology evolves. Keep putting Draconian restrictions on physicians and eventually the system will be left with few, and probably the ones that are left are not the ones you want. Wish I had answers. I don’t. Just observations. My thoughts are with you.

    Liked by 1 person

  9. Shout out to Ms. Drucker for being a Visiting Nurse. This blog has opened my eyes to so much that a physician goes through. Why would anyone want to be a doctor anymore? Teachers are also mandated reporters. One sad thing is when I found out about some of my young girl students in high school were being abused by their boyfriends and they did not think too much about it.” yeah he hit me, I guess I deserved it” tough to report that.
    I am still so innocent in my ripe old age to not have any comprehension of why people abuse people.

    Liked by 2 people

  10. What a painful experience…the sacrifices you make to do what is morally, ethically right. I’m sorry for you, Doc. I witnessed some teachers going through similar issues when reporting suspected child abuse. So wrong to penalize the “messenger”. 💘

    Liked by 1 person

  11. One of the many reasons I finally gave up my nursing career after more than thirty years was the number of depositions I was having to give…only it wasn’t against family members, it was usually against an incompetent or abusive caregiver, even “professional” ones.

    Liked by 1 person

  12. I imagine the reason why some people fight back so viciously is because they’re afraid of going to jail. Maybe if there was a way to protect patients without putting their caretakers in a legal bind, the truth would come out more readily.

    Liked by 1 person

  13. I can’t imagine what you would go through. I saw it once as a Care Aid and I didn’t really know what to do. It’ not something they taught us in school at all. I just reported to my boss and left it with them. Oh and then there are the clients that hit on or abuse us (The Care Aids) My boss was there when I was being hit on by my clients Husband right in front of his wife. (She died while I was there that day too) My boss did nothing and left me there with him. Gah!

    Liked by 1 person

  14. So sorry that this is part
    of your career.
    I had a PhD friend, who
    left the counseling field
    for what you are talking
    about. Being on the side
    of DYFS (social services),
    he could not take the
    court appearances &
    damage to children.
    Why are you made
    the scapegoat when you
    are just doing your job?

    Liked by 2 people

  15. People very often jump to conclusions and hop on bandwagons without thinking. A lot of people don’t want to think for themselves. Those people can be easily manipulated to a point where the truth, even if it can be shared, is meaningless. I’m sorry you end up in this situation.

    Liked by 1 person

  16. You’re damned if you do and damned if you don’t. Doctors are considered mandated reporters (or were when I was still a caseworker almost a decade ago), so not reporting when something seems off will get you in trouble, too. You’d think there’d be more laws in place to protect the most vulnerable and doctors who speak up for them would be lauded.

    Liked by 1 person

  17. Thank you for reporting. I’ve had friends whose abuse was not reported by nurses or doctors despite how there’s no way a child could injure themselves so severely on their own and in such sensitive locations.

    Liked by 1 person

  18. Ugh. I worked as a mental health counselor with children and was legally required to report suspected abuse and neglect. It almost always created a ruckus and invariably altered or ended the relationship with the family. Social media never came into play, but I can see how it could be terribly damaging and stressful. But the alternative, not reporting, isn’t an option. Every citizen should have a zero tolerance level for abuse.

    Liked by 1 person

  19. I am so glad that I am not in charge of Heaven. If I were “Him” I would reserve a special kind of Hell for abusers, particularly child abusers – and an even greater and more special kind of Hell for animal abusers, like the two lovely teenagers who thought it was fun to cut off the dog’s ears.

    Liked by 1 person

  20. A friend of mine who is a teacher says its almost impossible to get this right…people who abuse others will stop at nothing (right, Mr. President?). They will lie and fight in the dirtiest way they can. I admire you for being willing to brave these kinds of battles for the vulnerable. What a world we live in. (K)

    Liked by 1 person

    • The process leading up to the appointing of the guardian has been my experience. I have only ever been involved in adult abuse cases. Typically once the guardian is appointed your job is done. The ones involving kids are worse, though. They drag out in the courts for ages.

      Liked by 1 person

  21. We are increasingly beginning to pay the price to act as humans, or plain decent folks.
    On “marching and madness”? We are all in deep sh.. Never before had I heard the word impeachment pronounced even before a President was sworn in. He reminds me of Stephen King’s clown. Extremely dangerous. For the entire world. You might want to see Keith Olberman’s (he) “is not sound of mind and should resign”. Wars have started for less.

    Liked by 1 person

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