The Family Meeting
A meeting between family members of a sick patient and the various health care professionals taking care of the patient sounds like such a good idea. It may actually be a good idea. But for me it is truly one of the circles of hell. Spending half an hour or fortyfive minutes in a room with social workers, clergy, nurses, patient advocates and a pack of distraught and angry family members..... It's hard to describe the horror.
These meetings are usually set up when it is clear that the patient is not going to survive, yet no one has made the rational decision to withdraw aggressive support and allow the patient to die in peace. The meeting usually starts with me giving my "Grandma is toast" speech, followed by a sermon on the circle of life. You know, to every thing, turn, turn, turn.
Then the family members get to vent their anger at the doctors and nurses caring for the patient. For reasons known only to God, family members are often hostile and angry, rather than grateful for all the hard work and long hours put in taking care of their loved one. I can count on one hand the number of times a family member has said something nice to me. You know, something on the order of "Thanks for staying up all last night and saving my husband's sorry ass". Mostly it's just a litany of complaints. I understand that this is how people sometimes react to the potential loss of a loved one and that I should just stay calm and understanding. The problem is I'm an ICU doc. If I was calm and understanding by nature I would have gone into Family Practice or Endocrinology. Besides, it's easy to be calm and understanding on a full night's sleep.
Anyway, the characters at these meetings can be pretty entertaining. When meeting with family members of an elderly, critically ill patient one seems to run into the same characters over and over again. First, there's the TAD (Totally Annoying Daughter). This is the daughter who has seen a couple of shows on Oprah and reads People magazine and therefore feels qualified as a medical expert. The TAD's main premise is that if the fucking doctors had only listened to her in the first place her mother wouldn't be in this mess. Amazingly, the TAD has usually just flown in from 2000 miles away and hasn't paid the slightest attention to her mother for the last 10 years. Now she wants everything done and won't even discuss withdrawing support. On the otherhand, there's the daughter who has lived locally and has been lovingly caring for her mother, driving her around, making meals for her, taking her to see the doctor, etc. When she can get a word in edgewise she usually says something like "Mom wouldn't want to be kept alive on all these machines. She always told me that when her time came, to let her go join Dad".
Well, in the end the Angel makes his visit. At these times we're more like allies than enemies. I generally just nod hello and go on about my work. Occasionally I flip him off just to let him know where I stand, that next time he'll have to fight for his prize.
These meetings are usually set up when it is clear that the patient is not going to survive, yet no one has made the rational decision to withdraw aggressive support and allow the patient to die in peace. The meeting usually starts with me giving my "Grandma is toast" speech, followed by a sermon on the circle of life. You know, to every thing, turn, turn, turn.
Then the family members get to vent their anger at the doctors and nurses caring for the patient. For reasons known only to God, family members are often hostile and angry, rather than grateful for all the hard work and long hours put in taking care of their loved one. I can count on one hand the number of times a family member has said something nice to me. You know, something on the order of "Thanks for staying up all last night and saving my husband's sorry ass". Mostly it's just a litany of complaints. I understand that this is how people sometimes react to the potential loss of a loved one and that I should just stay calm and understanding. The problem is I'm an ICU doc. If I was calm and understanding by nature I would have gone into Family Practice or Endocrinology. Besides, it's easy to be calm and understanding on a full night's sleep.
Anyway, the characters at these meetings can be pretty entertaining. When meeting with family members of an elderly, critically ill patient one seems to run into the same characters over and over again. First, there's the TAD (Totally Annoying Daughter). This is the daughter who has seen a couple of shows on Oprah and reads People magazine and therefore feels qualified as a medical expert. The TAD's main premise is that if the fucking doctors had only listened to her in the first place her mother wouldn't be in this mess. Amazingly, the TAD has usually just flown in from 2000 miles away and hasn't paid the slightest attention to her mother for the last 10 years. Now she wants everything done and won't even discuss withdrawing support. On the otherhand, there's the daughter who has lived locally and has been lovingly caring for her mother, driving her around, making meals for her, taking her to see the doctor, etc. When she can get a word in edgewise she usually says something like "Mom wouldn't want to be kept alive on all these machines. She always told me that when her time came, to let her go join Dad".
Well, in the end the Angel makes his visit. At these times we're more like allies than enemies. I generally just nod hello and go on about my work. Occasionally I flip him off just to let him know where I stand, that next time he'll have to fight for his prize.
posted by ICUDOC at 8:15 PM
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