Wrong Way To Lose A Patient
Daily Observer
S.Q.
Lapius was not wearing his better mood when he arrived home. He affected a scowl which allowed his glasses
to slip down his nose. With focus gone
astray he tripped over a foot stool and barely recovered his balance, sparing
me the embarrassing effort of attempting to help him upright from the supine.
“Must
have had a busy day,” I commented.
“Quite. I lost a patient,” he said.
“That
happens to the best of us,” I commiserated.
“No
I don’t mean that way. I mean there is a
patient who will not avail herself to my services anymore.”
“That
happens to the best of us too,” I commiserated again.
“But
this should not have happened. She may
be in jeopardy,” he said.
“Then
the other doctor will straighten it out,” I said.
‘Not
if her husband has his way.” Lapius said.
“Out
with it Simon. You are being either coy
or cryptic,” I said.
Lapius
poured himself a sherry and sat down, hoisted his feet to the hassock and
sipped slowly. “Maybe women’s lib should
interest themselves in this case,” he suggested.
“Maybe
they should,” I said. “What happened?”
“My
patient was a woman. One of those people
who come to the doctor to hear confirmations of health. Let’s call her Fearful. She brings her husband to the consultations
to cushion her against the bad news, should it arrive, and to protect her from
evil – that is, the doctor. Let’s call
him Overlord. Well, as luck would have
it, a complete physical examination on this apparently healthy female turned up
some abnormalities in the protein patterns and the highest carcinoembryogenic
antigen level I have yet recorded. I
suggested to her that she must have a barium enema, gastrointestinal series,
proctoscopy and perhaps other studies.
After all, Harry, bowel lesions are curable when caught early,” he
explained as if I were on of his freshmen students.
“She
balked,” I prompted.
“Quite
the contrary. She agreed. But a few days later her husband called and
cancelled the tests. I asked him to come
to the office,” Lapius said.
“Did
he oblige?” I asked.
‘Indeed. He wanted to know why I had ordered the
tests, and I wanted to know why she cancelled them. I explained that there was a good statistical
possibility that she had a cancer hidden somewhere, and that her life might
certainly be threatened if we failed to look for it. He thought about that for awhile, then
decided that tests would not be done.”
“A
few weeks later she was in the office for some minor complaint and I
reintroduced the subject. ‘After all,
madam,’ I said. ‘I ordered the tests for
a good purpose, not frivolously.’ Until
then I had decided that it would be cruel to tell her why I had wanted the
tests, but now I felt that I must try to break down her resistance. I explained as carefully as I could the
implications of the tests results, and that indeed if she did have cancer of
the bowel early detection would be lifesaving.
As I expected, she said she would think it over, which, translated,
meant that she would go home and talk it over with Overlord.”
“Two
weeks later I received a nasty letter from Overlord who excoriated me for
informing his wife of her risks. He
accused me of purposely frightening her, and implied obliquely there would be a
law suit if my disclosure cased her undue mental anguish.”
“Wow,”
I exclaimed. “He could never win a suit
like that.”
“Of
course not,” Lapius snapped. “But he
certainly is taking on an odd responsibility.
I have not been aware that being a husband confers life and earth powers
over a wife.”
“Certainly
you must be correct. Are you going to answer him?” I asked.
“I
did. Although it won’t do any good. I pointed out that unless he had assumed
legal guardianship, or had the power of attorney to act in her behalf in
medical matters, he had no right to interfere,” he said.
“Did
it occur to you that this might be the perfect crime?”
“I
didn’t bother with that, Harry, because I knew it would occur to you.”