Monday, March 16, 2009

If dad was a cat, would Duke Medical euthanize him?

It is very early on a Monday morning. Dad is wide awake, moaning in pain and, of course, that means that I am wide awake.

Pain is scary for someone who cannot ambulate normally. It is especially scary because if he needs to move, he is afraid of falling. And night time is very dark and quiet and lonely.

As I have told Duke orthopedics for several weeks, dad is in pain because his foot looks bad and (inter alia) the surgical pins placed by the Duke orthopedic surgeon are moving out and jamming into his otherwise unaffected skin.

[enter sound effects of empty, no one is listening - like perhaps the sound of wind through trees]

Since Duke Medical has not provided me with any wound management care whatsoever, I am very literally winging it. I clean the foot every day. I put a prescription numbing agent on the foot (where I try to manipulate the surgical pins out of his skin). Since Duke orthopedics does not get the pain aspect of this for my frail 75 year old dad with cancer and 1/2 a foot, I give dad 3 Aleve. This does little to help dad. But I manage to be able to work quickly enough to get dad's skin fixed.

I am getting the sense that no one at Duke is really going to help dad. That makes me sad. It makes my mom inconsolable

Dad has been in such pain that it is difficult for him to get onto his knee scooter and get to the commode. And so he has accidents. Poor guy. It makes dad feel (in his words) "pathetic."

I spoke to dad's urologist's office on Friday. Those people are amazing. The support staff actually focuses on the patient's needs and gets a plan together instead of expecting the patient's family to coordinate the care. Of course, the urologist is not associated with Duke Medical - he is with Triangle Urology Associates. Dad's phenomenal urologist (Brian Evans, MD) will see dad this coming week!! Dr. Evans was in surgery all day Friday. Believe it or not, Dr. Evan's nurse helped me by finding another doctor to make a suggestion to help dad before dad could get to Dr. Evans. What amazing human beings!!

Did I mention that Dr. Evans is not affiliated with Duke?

If dad was a cat and in pain, incontinent and with a lame foot, I wonder how the current Duke "team" would "treat" dad. It seems as though Duke Medical has quite literally given up on my dad:

1. No Duke physician is stepping up to put together the plan for care by communicating with other physicians (a plan by the way that was almost in place - except the wound management - when dad left the 3-week hospitalization in November 2008);

2. Duke support staff consistently try to "protect" my Duke physicians from having to be bothered with my dad (that is a technique of putting up walls and Duke support staff have it down to an art-form);

3. Despite my repeated pleads, no member of the Duke medical team has treated dad's infection since January 2009 and that seems like "giving up" to me;

Despite my repeated pleads, no member of the Duke medical team has treated dad's wound or provided wound management since January 2009 and that seems like "giving up" to me;

5. Duke orthopedics does not provide my dad with any pain medication whatsoever when they have been told he is in great pain and losing sleep and becoming fearful because of the pain.

Based upon the empirical evidence, if my dad were a cat, Duke Medical would put my dad down. Old cat with lots of problems.

I suspect that the deal breaker for putting dad "down" like a cat is that assisted suicide is illegal in the United States. Ahhh . . . just wait for Obama's universal medicine.

So instead of putting dad "down" humanely, Duke Medical is forcing this man to suffer through a painful and depressing life. Duke Medical's treatment has reduced my very intelligent and self-motivated man to a hopeless and detached human being. I barely recognize my dad and it makes me sad. It makes my mom/his wife inconsolable.

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