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</font><blockquote><font size="1" face="Verdana, Arial">quote:</font><hr /><font size="2" face="Verdana, Arial">Originally posted by AndrewA: <strong> LM,
I read that you wound up operating on the OM after he and your wife were in an auto accident. My question is this: did you have a choice? Was there another surgeon there who could have done the surgery?
If there was..what was the thought process that led you to do it?
One other question: as I understnad it, the oath that doctor's take stresses that, above all, you should do no harm. Given that, would it be ethical to decline to do a surgery in a situation where you had intense ill-feeling toward a patient that might lead you - consciously or not - to do less than your best work in the operating room? </strong></font><hr /></blockquote><font size="2" face="Verdana, Arial">Andrew:
These are all GREAT questions. I will try and give you my feelings on them. There were "other" surgeons technically available to do this surgery, but locating them and getting them into the OR right away was/is problematic. I was the trauma surgery attending on call and thus it was my responsibility to be the chief surgeon here. I could have tried to get another surgeon (from home, who was not on call) to come in and do the surgery. It was in my professional judgement that time was of the eseeence and this patient (OM) could not wait what could have been another hour to get him on a table and locate his bleeding source. It may seem like an easy thing to just get another surgeon in there, but the system is not really set up that way. I am a trauma surgeon, and getting another ATTENDING surgeon right "then and there" would have been difficult. AS per my recollection, there was a cardiac surgeon actually on premises but he is not really qualified to deal with this type of trauma. He could do a bypass for me or crack this guys chest, but he just does not have the RECENT EXPERIENCE dealing with these types of inuries. I took the OM to the OR with my chief resident and I let him play a big hand in the case, but ultimately any outcome (good or bad) was on my shoulders. If I had to do it again, I would probably do the same thing, as I truly believe that if we even waited another 30 minutes and not stabilized his injuries he would have died. THe OM had a liver laceration that would have killed him had we not gotten his bleeding stopped, IN addition he had a ruptured spleen. LIke I said, we were quick (I had him on the OR table with an anesthesiologoist inside of 18 minutes). As a trauma surgeon you have to have a certain confidence and skill set. YOu have to know when to operate and more importantly at times when NOT to. I, in my heart of hearts, believe that I was the most qualified person in the hospital AT THAT TIME to give this patient a chance to live.
WHen you are dealing with this stuff, you learn to tune things out. When I reflect on all of this I sometimes get very anxious actually living out the situation in my mind, but AT THE TIME this was like any other of a thousand cases I have done. I don't think that any surgeon/physician with even a modicum of decency could ever do LESS than their best work..IRREGARDLESS of how we feel about a patient. Trust me Andrew, I have taken many worthless human beings (drunk drivers who have killed a family of four) to an opearing room and saved their lives. After the first night I obviously and correctly recused myself from this case b/c at that time, there were OTHER physicians who would better meet the OM's needs as a physician. This case is obviously a moral dilemma and we have discussed it in a surgical M & M conference that is "closed door". We can all debate what the right thing to do was, but in that moment of time, it is extremely difficult to know what the right thing to do is. In a million years I would have never expected to be in this situation, and you never know quite what you will do untill you are put in this situation.
I do NOT want anyone to think I am some kind of hero...I am not. I am a doctor who was blessed to have an ability to do this kind of work. This doesn't make me any better of a human being than a guy who works 2 blue collar jobs to put food and clothes on his children. I would think that the majority of you, if placed in my shoes, would do the same. I don't think placing my prejudices and pain with regards to the patient (OM) and getting another surgeon, thus delaying his OR case, would have served him better. I really don't. This doesn't make the situation any easier for me to reconcile, but in my heart, I did the best I could. EVen if he died (and I contend he still should have) I could have lived with the outcome......although admiteddly it would have been a much difficult situation for me to answer to. I have the support of my dept chair and chief, although we all under closed doors have breathed huge sighs of relief for this outcome. That I will admit. <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" />
You guys have recently made me wonder if I should submit my story to a surgical journal or New England Journal of Medicine under "ethics" to see what others would see. I honestlty now just don't want to deal with any possible negative consequences, so I let "sleeping dogs lie".
LM
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</font><blockquote><font size="1" face="Verdana, Arial">quote:</font><hr /><font size="2" face="Verdana, Arial">Originally posted by KMEJ: <strong> Lemonman- why are you mad at me? What did I say? I think you are directing your hurt and anger at the wrong person here- I never commented on your money. I think it is great that you are so generous. Yeah you are a doctor, doctors make a lot of money- but I have not seen that go to your head- you are very giving, careing and generous.
You never did answer what you are getting your nephews as I could use some more ideas- mom gets "boring" as my kids tell me!!
Hope your day is going better. </strong></font><hr /></blockquote><font size="2" face="Verdana, Arial">No KMEJ, my post was directed at Frederickgirl. I honestly don't feel I brag about money, but some people may see it like that. WHat I may have in money, I sorely lack in other areas, so you see, noone ever sees the total picture. KMEJ, I think you are a kind, caring woman who was dealt a bad deal with your WH. I know that you would never post something like this to me. <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" />
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LM:
We are dying to know:
Did OM thanked you for saving his life?
Did you have a chance to see OM after he woke up? If you did-------- what words were exchanged?
I suspect OM did not have health insurance, so you did not get paid for several hours of very hard work. Is that correct?
Did your wife ever asked you if you felt like letting OM bleed to death?
Why did you go so public with this? You could have operated the guy and no none would have known he was the OM.
Does OM still have a colostomy? <small>[ December 09, 2004, 03:18 PM: Message edited by: Stanley568 ]</small>
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</font><blockquote><font size="1" face="Verdana, Arial">quote:</font><hr /><font size="2" face="Verdana, Arial">Originally posted by Stanley568: <strong> LM:
We are dying to know:
Did OM thanked you for saving his life?
Did you have a chance to see OM after he woke up? If you did-------- what words were exchanged?
I suspect OM did not have health insurance, so you did not get paid for several hours of very hard work. Is that correct?
Did your wife ever asked you if you felt like letting OM bleed to death?
Why did you go so public with this? You could have operated the guy and no none would have known he was the OM.
Does OM still have a colostomy? </strong></font><hr /></blockquote><font size="2" face="Verdana, Arial">Stanley:
YOu want answers don't you? <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" />
The OM and I NEVER have had words since that night..we didn't really even have words that night as he was intubated almost immidiately in the trauma bay. The OM sent me a long letter of sincere gratitude, yada yada yada....it didn't really touch me. He is getting a divorce from his wife (he has 2 small children) and I suspect (pretty much confirmed) desires my wife still.....they will eventually be together....and they deserve each other. My only regret is that I could not hand deliver her to his apt with a bow tied around her neck <img border="0" title="" alt="[Big Grin]" src="images/icons/grin.gif" /> Hey, I always wanted to stab him in the chest....at least I can say I did <img border="0" title="" alt="[Big Grin]" src="images/icons/grin.gif" /> (joke). He does NOT have the colosotmy bag any longer. I can imagine that wearing a colostomy bag was as humbling an exercise as you can get. Lord knows he needs it (as do we all at times <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" /> ).
The OM had insurance and yes I got paid for this, although I really draw a salary, so he didn't really pay me, he paid the hospital.
I didn't really go "public" with this. All it takes is ONE person in a hospital (notoriously gossip havens) and the word spreads. There wasn't any way for me to sweep this under the rug. Although, quite amazingly, NOONE obviously talks about this in my presence. It is the big white elephant in the corner of the room. I am quite sure this was in the gossip pipe line for months (and still probably is). It is ok, I am certainly guilty of listening to gossip and partaking in it, so what comes does go around.
My WW never asked me if I wanted to let him bleed to death. HOnestly, Stanley, anyone that knows me, knows that something like that would never be in my conscious (although certainly it is in my subconscious). As despicable as someone is, I could NEVER be the judge if they should live or die..NOONE on this earth should ever have that power...and as such, I would always do what I could to help them (assuming they wished this). My WW would never asked me this, she knows the answer <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" />
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LM:
Regarding the letter from OM:
Did he touched the topic of the affair?
Did he ask you to forgive him?
Did OM talked about love and why it had to be that way?
Did you reply the letter?
The behavior of this OM is pretty much par for the course. One thing I learned about OMs (more so than WWs) is that they have a strong sense of entitlement. I am quite certain that this OM did not thank you as profusely as any other Joe Blow patient that has been touched by you--------- Like I said these folks feel entitled.
An OM with nobility (obviously there is no such thing) would have ended the affair with your wife after realizing you saved his life. But, nooooooooooo, these folks are wired differently------- they are selfish individuals and they do not believe in the GOLDEN rule. Everything about this man reeks selfishness! The OM in our case is similar and I could cite behaviors and actions that point to a strong sense of entitlement and selfishness. Do you realize OM may be living off your money after you settle with your STBXW? He will no hesitate in using the alimony (if any) for himself. The fact that you have to earn that money with the sweat of your brow won't bother him one bit.
On this board someone asked me why I never had an affair. I said------ because I have compassion for a man whose wife wants to do such a thing. These OM have no compassion for their fellow man!
BTW, if something had gone wrong despite the fact that the medical care was of high caliber the OM would have talked to a malpractice lawyer ASAP. The fact that he is alive would not cross his mind. <small>[ December 09, 2004, 06:22 PM: Message edited by: Stanley568 ]</small>
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</font><blockquote><font size="1" face="Verdana, Arial">quote:</font><hr /><font size="2" face="Verdana, Arial">Originally posted by Stanley568: <strong> LM:
Regarding the letter from OM:
Did he touched the topic of the affair?
Did he ask you to forgive him?
Did OM talked about love and why it had to be that way?
Did you reply the letter?
BTW, if something had gone wrong despite the fact that the medical care was of high caliber the OM would have talked to a malpractice lawyer ASAP. The fact that he is alive would not cross his mind. </strong></font><hr /></blockquote><font size="2" face="Verdana, Arial">He did talk of the affair in the letter, but JUST AS YOU SAID, he justified it and said that "I didn't understand the connection" him and my wife have and always had"....He did ask me to forgive him, and freely admitted that he owed his life to me (humbling for him I am sure). I did NOT reply to the letter, NO REASON to IMO.
Stanley, you bet your A$$ he would have talked to a malpractice lawyer had there been a unfavorable outcome. It doesn't matter though, as you are well aware, if you follow the standard of care, and DOCUMENT, DOCUMENT, and DOCUMENT, you will rarely LOSE a lawsuit (notice I didn't say NOT be sued). I have been named in three lawsuits (been subsequently dropped from all three <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" /> . There are few things that can inspire as much anger as being sued for malpractice when there was no malpractice. A bad outcome is NOT the same thing as NEGLIGENCE. I hate the legal profession. Yes, I know that is a gross stereotype and irrational but it is how I feel nonetheless. <img border="0" title="" alt="[Smile]" src="images/icons/smile.gif" />
LM
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Hey Lemonman, Glad to here you are not upset with me. I just had to make sure because your post was below my quote. I did not think you were, but one can never be sure!! <img border="0" title="" alt="[Razz]" src="images/icons/tongue.gif" />
Very interesting to read about your letter from the |M. I find it funny that he can say in the same letter "hey thanks for my life, and your wife" which is pretty much my take on things.
I feel for those small children. They have a long life of fighting parents, running at holiday (you aren't suppose to do that until you are married <img border="0" title="" alt="[Big Grin]" src="images/icons/grin.gif" /> ) and never feeling good enough.
I do not think you brag about money, I think you show that you care about others and are willing to help. A great trait to have.
I think you are a nice guy that fell in love with the wrong girl... You seem very smart and giving, talented, courageous and strong.
Hang in there.
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LM- like you, I have discovered a big re-assessment of what I value most. I have only scratched the surface of restructuring my household, re: giving away "stuff" that used to be important to me and simplifying my life.
I think it's related to the trauma we go through: what IS really important after all? What is worth investing my time, energy and money in? Maybe, too, the clutter is symbolic of a cluttered life? Maybe it's passing on the largess to others who need it?
I over-analyze, maybe. But I do know it feels good not to 'need' (former attitude) and to rather reflect on what's really important to me...
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I too have simplified my life. I am more at peace with staying home and not going out. i had a period during the A that I HAD to have the freedom I had not experienced- as I found out about my oldest son the day before senior prom, got an apartment with H exactly one week after turning 18 (I had moved out when I was 17 but had to stay with someone my parents approved of to avoid being reported as a runaway) bought my first house at 19, got married at 20, had second child at 22 and third at 25- and there I sat at 25 with a newborn baby and a H flaunting his relationship in my face. I started going out and dancing (I love to dance!!- never get to go anymore as H hates it and gets mad if I even suggest going out with the girls). Anyway I am now 26 trying to "fix" my marriage and I am okay with my responsibilites. Where H is spending money on what ever he wants, does what he wants, and borrows thousands of dollars to his friends with no jobs or who make bad choices to bail them out of a bad situation. H I belive still wants to have his teenage freedom back and had a taste of it with the OW who was a teenager- I see slight improvement- however I am not sure he wants back into reality quite yet!. If that made any since at all.
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