What the medical profession can learn from this patient


A excerpt from A Mind Unraveled: A Memoir. Copyright © 2018 by Kurt Eichenwald. Published by Ballantine Books, an imprint of Random House, a division of Penguin Random House LLC. All rights reserved.

I awoke in pain. Sometime during a seizure, I had fallen down the stairs outside of my bedroom and banged myself up. I suspected I broke a bone and decided to get an X-ray once I was more coherent. About an hour later, I hailed a cab and asked to go to the nearest hospital. Any doctor, I figured, could find a fracture. The cabby dropped me off at Capitol Hill Hospital.

I remember little that followed, but my father later told me what happened. Someone checked my blood sugar levels with a test strip. The person wrote down the results incorrectly, stating they came from a complete glucose test—involving drawing blood—rather than the finger stick that was performed. Mistake piled on mistake, and soon a doctor diagnosed pancreatic cancer. I may have gone into convulsions in the emergency room, and my planned short visit turned into a major hospitalization.

No one checked my MedicAlert, which disclosed my epilepsy and instructed medical teams to check my wallet for a card with my anticonvulsant schedule and emergency contact information. As a result, the hospital stopped providing my medication. For days, each time I went into convulsions, the staff infused IV valium to stop the seizure. At one point, I opened my eyes and saw my friend Neil Fisher standing by me. I didn’t know how he had ended up there, but I recognized I was in danger.

“Call my parents, and tell them to get here right now!” I begged him. “Tell them this is an emergency!”

Later that day, I was admitted to the intensive care unit.

I woke with someone stuffing pills into my mouth. I pushed up my tongue to block them, then spat them on the floor. I recognized the red bands around the white capsules; it was Dilantin, three times my normal dose.

A short, dark-haired man stood beside me. “Get the fuck away!” I growled.

“You need your medicine,” he said.

Right. In my sleep. At triple the dose. “Get away from me, or I’ll scream!”

I watched him leave the enclosed area and saw my parents in a main room. My father was confronting a doctor. They were too far away for me to hear the words, but I could tell Dad—who as a leading academic physician had plenty of experience brutalizing unprepared interns and residents—was ripping apart the other physician.

As staff members rushed about, producing records for my father, my mother saw I was awake and came to my bedside.

“Are you all right?” she asked.

“Feel like I’ve been hit by a truck,” I said. My tongue moved as if coated in molasses.“What happened?”

She told me I had been in the hospital for days and that the doctors had made one terrible gaffe after another. The medical team learned of my epilepsy only when my parents arrived. At first, the doctors insisted they had given me my medication, which set my father off: How the hell would they have known to provide me with my prescribed anticonvulsants if they didn’t understand I had epilepsy? He called the doctor a liar to his face.

My father came in with my chart. “Don’t worry about how you feel; it’s not because of something wrong with you. You’re in intensive care. The doctors made a mistake with a blood sugar test and decided—but you don’t!—they incorrectly decided you had pancreatic cancer.”

“From one blood sugar test?”

My father shook his head. “Don’t get me started.”

“Why do I feel so awful?”

“They’ve been giving you IV valium every time you had a seizure, and they’ve used too much. It settles in muscles and fatty tissue. Don’t try to get out of bed. You’ll fall.”

Another man arrived who looked familiar, a Washington lawyer who was friends with my family. He had picked up my parents at the airport and driven them to the hospital.

Soon after, my boss, Hedrick Smith of the New York Times showed up. Assuming he would be panicked by my disappearance, my mother had notified him I was at the hospital in intensive care. When he saw me, his usual expression of calm assurance drained away, replaced by a look of shock.

The area around my bed was packed, with everyone listening to my father explain the incompetence I had faced. At some point, a doctor burst in, angry about the number of visitors surrounding my ICU bed.

“Who are all you people?” the doctor barked.

My mother stepped forward, gesturing to each individual as she made the introductions. “I’m his mother, this is his father, this is his lawyer, and this is Hedrick Smith of The New York Times.”

They all stared at the doctor in silence. “Oh,” he said. Then he scurried away.

Within the hour, I was transported to Georgetown University Hospital to recuperate from the damage caused at Capitol Hill Hospital. The doctors diagnosed a valium overdose but also found that my anticonvulsant levels had dropped below the therapeutic level. When sufficient time had passed, a doctor told me they were going to infuse Dilantin. I asked what that meant.

“We’re giving you a load of Dilantin directly into the bloodstream,” he explained.

“You know I have a lot of valium in me?”

I heard a voice. “They know.” It was my father, who was beside my mother in the room. “They’ve been monitoring it, and it’s okay now.”

It’s okay? Already? “How long have I been here?”

“Since yesterday,” my father said. “You’ve been sleeping.”

I remembered: My shoulder. It didn’t hurt anymore.

“What happened to my shoulder?”

My mother spoke. “That was a dream. Nothing happened to your shoulder.”

“No, it was real. That’s why I went to the hospital. I fell down the stairs and hurt my shoulder. What did the X-ray show?”

“That’s why you were there?” my father asked. “We assumed you had been found on the street.”

“So what did the X-ray show?”

My father seethed. “They didn’t take an X-ray.”

The doctor beside me asked how my shoulder felt now.

“It’s fine,” I said. “Guess I would have been safer if I had just stayed home.”

Time detached from reality. There were moments of consciousness, then not. Hours, perhaps days, passed without my taking notice.

My next memory is of a middle-aged doctor knocking on my door and asking for permission to speak with me. He walked in with a group of fresh-faced young people in lab coats, then introduced himself.

“These are medical students,” he explained. “I’m visiting patients with them and was hoping you’d be willing to talk to them about why you’re here today.”

Damn straight I’ll talk to them.

I chose my words carefully. “I’m here because a doctor at another hospital failed to take a proper medical history. The doctor—not a disease, not some chronic medical condition—injured me so badly I had to be brought here.”

I gave an account not just of the latest near-fatal mistakes but also of the times over the years when doctors failed to ask questions, conduct follow-up, or listen. By shortchanging the importance of a patient’s past, doctors could cause incalculable damage, I said.

I studied the students’ faces. Do they understand?

“So someday, when you have a patient in front of you, remember me. Remember how bad I look right now,” I said. “Remember this happened because a doctor didn’t take a proper history. All the labs and machinery are useless if you don’t talk to patients extensively.

“You need to ask about their health and about their medications. You need to look them up in the Physicians’ Desk Reference to know if they’re taking the right amounts or are on drugs that conflict. Don’t let gadgets and drugs be your first thought. Ask questions. Write down the answers. Figure out why those answers are important and what they show.”

I ended my lecture, and a few students tentatively asked questions.

Then the doctor told them to head to the hallway.

“Thank you,” he said to me. “I wish I had recorded that.”

Kurt Eichenwald is a journalist and author of A Mind Unraveled: A Memoir.

Image credit: Shutterstock.com

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