Reflection of Day 1

The discussions today were thought provoking and inspiring. There were multiple times today that we discussed how a patient and/or their family would want answers and open communication after an adverse event.  This was the nudge/chastisement I have needed to take action to try to remedy unhealed wounds.

I had a patient, who I was the PCP for, die about 3 months after I had started seeing him. He presented to me in the clinic with vague symptoms that I tried to work up over the next 2 months but failed figure out what was wrong. He was eventually hospitalized and then diagnosed with advanced lung cancer. I saw him in a follow up visit and he was supposed to be starting chemo but miscommunications kept happening between the patient and the oncology clinic. I tried to get involved and help figure out what could be done for him, but after 2 unsuccessful attempts, I too let things slip through the cracks. I went away for a week to a conference only to return and find out that he had rapidly worsened to where his pain was unbearable and he suffered terribly for 5 days before finally getting put on hospice only to die that night, 2 days before I had returned.
This was my first patient to pass in such a poor manner in whose care I was directly involved. I struggled deeply both with the fact that I had failed to diagnose his cancer sooner, failed to do more to make sure his oncology visits were set up, and failed to help him be comfortable in his final days of life.
I had planned to attend the funeral but chickened out at the last minute. I worried what people would think if they knew I was the doctor that had failed to save his life. I then wrote a heartfelt letter to his wife and went to deliver it only to have the wrong address. After figuring out the right address, I have still not made any contact with her. I have been worried that she will have resentment towards me for my failings. Today’s discussions have given me courage to do the right thing and the thing that my heart desires to do.  I plan to reach out to the patients wife upon returning home from this conference.