Risking Quality Health Care because of Bad Family Decisions

I entered the room. It was dimly lit. He slowly opened his eyes as I got nearer. It was already 2:30 in the morning.

I was about to speak when he smiled and said, “Thank you for coming”

I smiled back. I kept silent. I bent down looking at his urine bag. “I am glad to see that you are not urinating blood this time, sir.”

“I think I am feeling a little better now. Weak, but a little better”

“Well that is good to hear, sir. If everything turns out well then probably you’ll be discharged the day after tomorrow.”

“I was destined to get this cancer. It took a while before my wife told me that it was cancer. And now, here I am. I do not know if it was the right thing to do – to keep the diagnosis in secrecy. But right now, the only thing on my head is that when it is time to go, then I will have to go. Irregardless of whether they decide to start me with chemotherapy or not. It will not matter anymore.”

I stood there, and nothing came out of my mouth. What should I say?

The silence broke when his wife woke up. “There you are doc, sorry I didn’t hear you come in”

“It is alright. Ill see you again tomorrow. You get well sir”

He smiled as he gently close his eyes.

As I walked away, I felt really bad for this man.

I did an endoscopic biopsy on him about a year ago, and it turned out to be cancer. I told his family about it, but his wife insisted on not divulging that it was cancer. She said that he will be emotionally depressed when he finds out that he has cancer.

I explained to them that it is imperative for him to know about his condition since he’ll be needing other treatment. He was not a good candidate for a radical surgical procedure, but chemotherapy can help. So I insisted that he should see an Oncologist, for him to get the proper chemotherapy program. They finally agreed.

But they never came back for follow up check-up.

Two days ago, he was brought back to the hospital and was admitted due to hip fracture. His cancer metastasized to his bones making it fragile and weak.

Yesterday, I asked his wife, “Why didn’t you bring your husband to the Oncologist? The last time we met I insisted that he needs chemotherapy for his cancer.”

“We didn’t want him to know that he has cancer. He will feel bad about it. He will be too depressed to live, ” she said softly.

“But look at him now! His cancer is consuming him. It has already spread to his bones. He is not fit to undergo the pelvic fracture surgery. In fact, he is too weak to undergo any surgery.” I said.

It occurred to me: telling your patient about his condition can be difficult. They are inclined to deny that they are inflicted with it. This situation more often occurs when you are dealing with a patient with cancer.
If the patient, or his relatives are in denial and remains skeptical about the treatment options that you offer, notice that you will lose this patient. They will distance themselves from you and either look for another doctor who would conform to their idea of management or search for alternative treatment.

As in this case, his relatives were in denial that it was cancer. They took their chances, and ended up with a bad decision.

Poor patient, he had no idea that it was cancer not until his second admission. They decided on his behalf. Everyone knew about his ailment, except himself. He was deprived of the opportunity to get the proper treatment that will at least halt the progression of the disease.

It was, in my opinion, a deprivation of one’s rights to get a quality health care.