Thursday, May 11, 2006


One of my patients is bleeding from his gut, probably from a tumour which will kill him in the next 7 days. Yesterday I tried to get an investigation done (an endoscopy) which may have enabled us to find out where and what the problem is and perhaps do something there and then (for example laser treatment) to stop the bleeding.

I asked the Consultant Gastroenterologist to consider doing this test as a matter of urgency as it may save his life.

The reply was "If he is going to die of cancer anyway in a week we don't really want to do the test; if there are complications it will put our mortality figures up and it isn't worth the risk. First I would like you to do some more tests to find out if he does have cancer so we can think again."

So he is sitting on the ward now, continuing to bleed from his gut. I have continued to give him blood transfusions to try and keep up, but by the morning (if he is alive) he will have had nearly 10 pints into him over the last couple of days.

And by the way, the other test that they asked me to get done was an ultrasound scan. My senior spoke to the consultant in charge of that test, and he was told that although he had free slots yesterday afternoon to do the scan, because it was not urgent it could wait until tomorrow afternoon.

My patient is dying in front of my eyes. I do not have the skills to do these tests myself and the people that do are dragging their feet. I am not happy with this situation. If this man dies it will be because the NHS has failed him. He will probably die anyway, but an extra day/week/month with his loved ones would be worth its weight in gold. I will be upset when he dies and I will continue to be despondant about the organisation I work in.


thegirl said...

My god, that is awful.

Forgive my ignorance and naivete, I really thought this type of nightmare situation only happened in the movies.

It's very depressing to know that it's happening right here and now in our NHS.

I really feel for you, what a bloody horrible situation you are in. Is there no-one above the Consultant Gastroenterologist who you can go to for a second opinion on the course of investigation/treatment?

angel, jr. said...

Wow. I'm rather speechless.
It's weird to me that people who went into medicine to help others, aren't lifting a finger to do so. I guess I'm still rather naieve about the whole system.

Kate said...

Remind me not to get sick in this country, 'kay?

Happy said...

I hope u have documented this in the patient's notes, sent an incident form and passed the consultant's comments to the patient and relatives discretly.....then sit back and watch how things are going to move FAST.

Vegas said...

I thought telling the patient and relatives would just add to their distress. So I just ignored what the consultant said and asked another gastroenterologist (a more junior one, ironically) who agreed to do the procedure. It was normal. A useful result, which enabled us to move on with the diagnostic process.

In my hospital, if you complain about something, you get into trouble for not being a team-player. Even if you are right. No-one wins.

The Venial Sinner said...

Yes, indeed: beware telling the pateint and relatives the things that happen behind closed doors or else you might find your own arse on the line.

Dr. Deborah Serani said...

OMG, I am virtually speechless. Managed care here in the US is terrible too, with similar things being said AND done. What on earth is going on here. I really feel for you and your patient.