Saturday, April 18, 2009

Is Duke Medical stalling in hopes dad will die?

I am not a medical professional. But I being educated both in practical experience and in tradition college classes.

I have followed each and every order and direction that Duke Medical gave me.

Dad was diagnosed with colon cancer 2 years ago. Following the directions of phenomenal clinicians in oncology, endocrinology and orthopedics were generally beneficial. Each and every of my dad's health regressions were due to the "stranger doctors" at Duke University Hospital.

But, this time, I followed every direction the doctors gave me. Every one. Dad should not be suffering right now. Dad should not be in pain every day.

Something very odd is going on at Duke Medical. I wish I were a fly on the wall.

My dad left a three (3) week stay at Duke University Hospital (DUH) in Durham, NC. The reason for the admission was that a Duke Hospitalists (i.e. "stranger doctor") ignored an obvious foot sore that was present throughout a two-week hospitalization at DUH. I explained to the "stranger doctors" and their ilk that dad had metal in his foot early that year and therefore he must wear the specially designed plastic brace.

I was told by DUH at discharge that dad needed strong medications 3x a day. That meant I would push medication through dad's chest port-a-cath. I watched the clock and gave the medication perfectly. I even had the opportunity to pursue a legal assistant job. Probably would have been hired. But I could not take a job because my dad is the number one priority in my life.

At discharge, I was told by Dr. Mark Easley that dad needed additional surgical intervention. However, according to Dr. Easley, that orthopedic surgery could not (and would not) happen until dad hit set mile-stones:

Okay. I can do that. Let's make it happen.

1. Dr. Easley stated that dad must be cleared by the Duke Plastic Surgeon (L. Scott Levin, MD) who performed plastic surgery to build a flap in the foot.

Permit me to digress. Dr. Scott Levin is one of my favorite Duke doctors. He was skilled, intelligent, personable, patient - all of this with just a dash of ego to assure me that he is indeed a surgeon. Great guy.

Dr. Levin cleared dad in early January 2009.

2.
Dr. Easley stated that dad must be cleared by the Duke Infectious Disease Clinic.

I really did not think this one would be a problem. The initial ID physician was phenomenal. Her name is Dr. Anna Person. My last conversation with Dr. Person via telephone and she told me that my dad need not return to the clinic. Dr. Person had a great rapport with my sick and scared dad. Dad felt safe.

But alas, Dr. Person was a Fellow on loan to Duke and therefore she left.


Dad was never transferred to another ID doctor's care.

The orthopedic surgeon was too busy to get another ID physician for my dad. And so I asked dad's Former Duke urologist (another amazing physician - Brian Evans, MD).

Dr. Evans gave me the best compliment that he possible could of Dr. Sexton. Shortly thereafter, Dr. Sexton telephoned me and assured me that he would evaluate and help my dad.

And sure enough, on April 10, 2009, I dragged my dad (not literally) from physical therapy to an appointment with Dr. Sexton. The doctor indicated that he certainly cleared dad for the final orthopedic surgery. Yippee!!

Dr. Sexton explained that either him or another member of the ID team would be present during the surgery to evaluate any remaining infection intra-operatively. Great. Dr. Sexton told me that he would get back in touch with me.

I took dad down for blood work.

Dad felt a renewed sense of life as he was beginning to accept that his days stretching out on the couch are not indefinite.

So where are we now? You'd expect dad would have the surgery lined up, right?

Remember that dad's Duke Clinic oncologist (Michael Morse, MD - one of my favorite human beings) told dad and myself in January 2009 that between the cancer and the foot . . . the foot was the priority. In fact, Dr. Morse would not even put dad through a CT scan because the doctor determined that any medication he prescribed for dad (if there was cancer remaining) would ruin any possibility that the foot would heal properly.

I cannot even attempt to explain the last week and the confusion between all of the doctors. Being blatantly ignored by dad's doctors at this critical time is a very lonely place to be.

Suffice it to say, by Friday afternoon, I concluded that (based upon my discussions with the Duke administration and the failure of any medical personnel to communicate directly with me post Duke administration involvement) Duke Medical was not interested in treating my dad and in fact the medical facility was stalling in hopes that my dad would die sooner rather than later.

I have never hoped that Duke proved me wrong more.

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