Friday, November 20, 2009

What if Healthcare Decisions Were Made Like the Budget.

A mother and her children waited in the waiting room of the Emergency room. The doctor stepped into the doorway, a grim look was on his face. “Mrs. Doe?”
Before he spoke the words, Mrs. Doe knew he had come out to speak to her. It was her husband that had been flown to the hospital via life flight following his accident on his way home from work. She had debated with herself on whether or not to bring the children because of this exact conversation. She didn’t know his exact condition except that it was critical. This may be the kids last chance to see their father. She stood up to face the doctor. “Yes. I’m Mrs. Doe.”
“I’m Dr. Obama, the chief of medicine at this Hospital. I know you have your children here, but I don’t know any other way to give you the news. Your husband has suffered substantial internal injuries from the impact. He is bleeding internally and his brain is at risk from not getting enough blood. I don’t know if he can make it. Now, I have an idea for saving him, but it will require your consent, which is why I am speaking to you now.”
“What is it. I’ll do anything.”
“Mrs. Doe, a crisis like this could cloud your judgment. I want to make sure you are allowed at least 30 seconds to compose yourself before you respond to my proposal. I also want you to know that I only plan on giving you some of the details of the procedure as you will not be capable of understanding its complexities, but you can trust me. “
Mrs. Doe was puzzled at the doctors statements, but he was right. This was a crisis and she needed to be prepared for anything. “What’s your plan doctor.”
“Mrs. Doe, his internal bleeding is causing a red blood cell count deficit. What I need to do is to jump start the red blood cell production. My plan is to insert a tube into his main artery and allow his blood to flow into an assortment of bags that will sit on a shelf and never flow back into his body.”
Mrs. Doe had no medical training, but she had watched Grey’s Anatomy on TV. “But doctor, won’t draining his blood cause a larger red blood cell deficit, eventually leading to his death.”
“Mrs. Doe, I know it seems contrary to logic. I’m sure you think I should go in and seal up the wound that is causing the internal bleeding and allow for his body to replenish itself.”
“Well, yes I would.”
“That is why I’m the chief of medicine and you are just a housewife. You aren’t seeing the big picture here. Next to your husband’s room is another patient, a Chinese man that is in need of a blood transfusion. Over the last several years, this man has given our hospital countless units of blood on loan. Now, he is calling in his loan. Unfortunately, our domestic red blood cells are not worth what they used to be, which is why we have to bleed your husband dry while his heart is still beating.”
“But he’ll die. Aren’t you sworn to save lives and not take them.”
“Exactly who have a sworn to Mrs. Doe? God or some ancient Greek philosopher? My oath is to medicine. You have 5 people in your family, and that’s a lot of blood, more than the average family unit. This crisis has allowed me to distribute the blood that your family hoards to those more in need.”
“But your giving it all to the Chinese man.”
“That Chinese man helped to get me elected to be the chief of medicine. I owe him”
Mrs. Doe was dumbfounded, she couldn’t believe that her husband was being bled dry right in front of her. The doctor didn’t even try to hide his intentions. She wanted to run into unit and rush her husband to another hospital, but which hospital would she go to. All of the other hospitals had been practicing medicine the way Dr. Obama was planning on doing now. Even though the patients were bleed to death, people still had to wait months to get in, and her husband didn’t have that kind of time.
While Mrs. Doe pondered her situation, a nurse entered the room to speak to the doctor. “Doctor Obama, we finished bleeding Mr. Doe. There’s not a drop left”
Mrs. Doe screamed, “What have you done. I never gave my consent.”
Dr. Obama tried to reassure her. “I’m sorry Mrs. Doe. Speaking to you was actually just a fa├žade. I don’t need your consent. I, along with my surgical procedure czar, made the decision before I even came to speak to you. I hope you understand that we had to act or risk losing your husband.”
“Risk losing my husband. What are you talking about, you killed him.”
“That’s what makes this so hard.”
The nurse interjected. “I’m afraid it’s harder than you think doctor. Mr. Doe was not able to provide all of the blood we needed. The Chinese man needs more blood.”
“Mrs. Doe, I’m afraid this news is no good. We still have a crisis. May I ask what blood type your children are?”

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