Wednesday, May 6, 2015

Dodging a Bullet

The army does not hand out generous transportation allowances, so it housed this family in a single room of a Days Inn. Arriving, I squeezed past stacks of luggage and between three rollaway beds where the children slept.

I suspected the officer’s wife had pneumonia. She looked sicker than usual: feverish and short of breath. While not alarming, it required some thought.

Doctors make most decisions based on evidence or gut feeling, but sometimes a third factor intervenes: inconvenience. For example, as a patient it’s risky to be the final appointment before lunch or at the end of the day. There’s a small chance the desire to get out of the office will influence the doctor. Rarely, this leads to a decision that comes back to haunt him. I’ve been around long enough to follow a rule: if I’m about to chose an option that saves aggravation, I do the opposite.

Leaving after giving an appropriate antibiotic for pneumonia was a reasonable option, but the rule applied. Reluctantly, I announced that she needed to go to an emergency room.

A major hassle followed. The father did not normally care for the children, so I sat patiently for half an hour as he woke them, struggled with their clothes, made several phone calls to reschedule his flight, then shifted a dozen boxes between his wife’s bed and the door. After this was well under way, I left to fetch my car, parked two blocks away. Fitting six people into a tiny Honda took additional effort.

It was a relief to usher them into the waiting room, explain matters to the clerk, and say my goodbyes. It was a greater relief to learn, when I called the hospital later, that the wife lay in the intensive care unit, intubated, and on a respirator, fighting a catastrophic pulmonary infection.

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