Friday, November 07, 2008

Peg's story

The next speaker at the seminar (below) was Peg Metzger. Peg has been involved professionally in health care issues for many years but found herself a patient harmed in a Boston hospital. Her story reinforced Tom's lesson about the anatomy of apology.

She went for an outpatient ERCP 18 months ago. Her small intestine was perforated. Septicemia and necrotizing pancreatitis developed, and she ended up fighting for her life in the ICU. As she entered the ICU, she woke up and heard people talking and realized that she might die and that the doctors didn't know if they could save her.

Peg spent 63 days in the hospital over 7 admissions over the next ten months. There were many unexpected complications and developments, and "I suffered pain that was unimaginable." "Each setback was emotionally devastating, but I always tried to be upbeat."

"The most upsetting aspect was my doctor's response. The doctor did explain that things had not gone well," but did not tell the details. Later, when the doctor explained more, I told her that "It was not your fault" to try to make her feel better. "Unfortunately that was the last time I saw her. In all my hospitalizations, I never heard from her again. I didn't know if she was even following my case."

"I was undone by her disappearance. This leaves me tormented to this day. My life matters, and I think she should have behaved as if she thought so, too. I thought she was my doctor, and she bailed on me. It was unfathomable to me. Her seeming indifference added layers of torture to my existence."

In addition, the GI department in which her case occurred never followed up in any way.

Peg offered four take-away messages for health care providers:

1) Overcome your fears and say something. Don't try to hide. The trust the patient has in you will turn to rage if you display seeming indifference.

2) Don't wait. Act sooner rather than later. What it takes to make the patient feel supported at the beginning is small compared to what is needed later when it has been neglected early on.

3) Study the work that has been done on this and learn the techniques that have been developed, so you'll be ready. But your words don't have to be perfect.

4) Patients who experience these events have been damaged and deserve remedies or reparations.


Ben said...

This is a very interesting story. I personally think teaching "Breaking Bad News" also deserves more priority in med and nursing school.
Also, I would like to share a link to a "plain English" resource on diseases, drugs, and procedures: MedlinePlus

Toni Brayer, MD said...

This story speaks volumes. (Meg, if you read this, I'm glad you are here to teach us all). Patients understand is the idea that the doctor DOESN'T CARE that really does them in. Seeing the patient through the entire illness and beyond is critical, even after the apology.