Let Grandma go with dignity, and a family’s inability to do so

I can always use money. Regardless of what the public seems to think, doctors are generally not phenomenally wealthy.

So I hate turning business away. But tonight I refused a hospital consult. Why would I do that?

Because.

The consult was for an 88-year old lady with advanced Alzheimer’s Disease. Her sad life was reduced to lying in bed staring at the ceiling.  The patient had been seen by 2 other neurologists during this admission, and 3 others in the year previously. All had told the family the same sad facts of the case.

Yet, the family called me last night for a 6th opinion. A granddaughter poured out this sad story to me, and begged me to come see Grandma. I asked her exactly why she wanted me to come in, since it didn’t sound like I had much to add. Grandma has already had every test in the book.

So granddaughter said, “Because the other neurologists just keep giving us bad news, and tell us to call hospice. We’re looking for someone who will tell us this can be reversed, and who can fix her.”

And that’s why I turned down the consult. Because I’m not going to be a party to this insanity just to collect $100 from Medicare. It’s not fair to anyone, especially Grandma. I bet she’d be horrified if she knew what was being done.

This is sad. But I won’t be part of this family’s denial issues. Me telling them the bad news for a 6th time obviously isn’t going to change their actions. They’ll just keep looking for someone who is either incompetent or willing to lie.

And that’s why I turned it down. Because I respect Grandma. I’ll never know who she was, but I doubt she’d want more docs being a part of her family’s inability to let her life go with dignity.

Doctor Grumpy is a neurologist who blogs at Doctor Grumpy in the House.

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