Today I worked with my favorite Gastroenterologist. He was a pediatrician, a famous one at a famous hospital, back in India. Once he came to the United States, and had to retrain, he decided to become a Gastroenterologist. Back home, his medical school classmates do not understand why he would leave a prestigious field like Pediatrics, and work as a less-respected field.
"There are three kinds of patients. The first are the PPO's. They are nice. The second are the HMO's. They are always angry because the referral did not go through right, and they had to wait for their care. The last are the GNP (an IPA in the area). They think that anywhere else besides the main fancy hospital people don't know what they are doing." he shared.
Apparently the main fancy hospital 'has everything, all kinds of equipment' because of the many donations. They have EUS and another new technology.
A nurse asked about the local teaching hospital. 'Don't they have those technologies too?'
'I would not let them treat my dog, unless I wanted the dog dead!' he said.
Apparently he had a liver biopsy. He wanted transjugular, but the colleague he went to only did transcutaneous. (His colleague of choice went to his alma mater, and he respected their common institution.)
In recovery room, after the procedure, my favorite gastroenterologist knew something was seriously wrong. 'I am bleeding.' he said, and asked the nurse to contact the doctor. The doctor could not be reached, and the nurse sedated him. (The bleeding was internal, and it did not show on the dressing).
He had called his wife at the gym before the sedative. When she got there, he woke up. Nothing had happened. He called his friend, another G.I. attending and explained the situation. He got admitted to the hospital. Again he called his doctor, but only a resident got sent.
He passed out again. When he woke up, he was getting 'a fluid challenge'. 'What is this? Why am I getting a fluid challenge?'
'Your blood pressure is 60 (systolic--a pressure incompatible with life)'
'What is my hemoglobin?'
'Seven' (He had fourteen before the procedure. He had lost half his blood volume).
He called his friend the surgeon. His friend sent up his fellow. In fifteen minutes he was in the O.R.
There were five liters of blood in his abdomen. (He was hanging on to life by a mere thread.)
Anyone else that was not a physician would have not known to pick up the phone, or even whom to call, and would have died. It took four years and half a million dollars to get his health back to what it was before. The reason he keeps working still, is to make sure he has good insurance coverage.
'It was a good lesson for me," he said. "First, I learned to take good care of myself. Second, I learned what it is like to be on the patient side of the doctor-patient relationship."
He took action, not legal, but with the hospital. A review was done. The offending gastroenterologist was offered the chance to leave or be fired. He left.
"But you know what?" he asked, looking me straight in the eye, giving me the chills.
"I had a bad feeling about this. Before the procedure, when we were in the car, I told my wife. She asked me do you want to go back home? I said, no, we are here already. I often wonder what would have happened if I had listened to that feeling and not gone through with it."