Ice Dancing

Dr. Michael Hebert: "I was just covering for the weekend. 'Just covering' means doing a lot of dancing on thin ice."

Room 441 looked easy. DNR was written loudly on the chart, telling me that the patient and family recognized that the end was near and were requesting that no resuscitation measures be taken...

I went in, and found myself surrounded by anxious family members. My stomach told me this would not be as easy as I had hoped. Yes, the family had consented to abandon all medical intervention except comfort measures, but they were not entirely comfortable with their decision.

The patient's middle-aged daughter was at the bedside, and I could tell that the eye of this storm of anxiety quietly spun around her. She had many questions.

She was probing me. Every doctor has this experience from time to time. A patient or family member is not entirely satisfied with another doctor's opinion, so she probes another doctor to see if he agrees. Each question and statement she made seemed a test to see if I would answer the same way my partner did. Did I agree with the diagnosis? The prognosis?

I strapped on my skates. Carefully I spiraled around every question, throwing in triple loops and double axels of knowledge to keep my answers sounding credible. This lady was very sick, and she would not last long. I tried to assure the daughter that the decision to limit treatment to comfort care was indeed the right one, even though ten minutes ago I did not even know this patient existed...

A powerful post. Highly recommended!